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NPI Code Detail

MEDICARE: CHRISTINA RILEY

MEDICARE: CHRISTINA RILEY
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
1103K00000XBehavior Analyst1093009193

General Provider Information

NPI Number : 1982077665
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA RILEY
Provider Business Mailing Address
First Line : 1912 LAKE FOREST LN
Second Line :
City : FLEMING ISLAND
State : FL
Zip : 32003-8660
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 782 FOXRIDGE CENTER DR
Second Line :
City : ORANGE PARK
State : FL
Zip : 32065-5776
Country : US
Telephone Number : 904-579-3280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2015
Last Update Date : 03/17/2018

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Directions to “ CHRISTINA RILEY ” Practice Location

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