MEDICARE: BRIAN D. RIKER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	5939	OH

General Provider Information

NPI Number	:	1659598357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN D. RIKER, INC.

Provider Business Mailing Address
First Line	:	2752 ERIE AVE STE 2
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2207
Country	:	US
Telephone Number	:	513-297-4511
Fax Number	:	513-297-4511

Provider Business Practice Location Address
First Line	:	2752 ERIE AVE STE 2
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2207
Country	:	US
Telephone Number	:	513-297-4511
Fax Number	:	513-297-4511

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRIAN DAVID RIKER
Credential	:	PSYD
Telephone Number	:	513-297-4511

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	02/13/2023

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