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General NPI Number Information
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NPI Number | 1245191618
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Entity Type | Individual
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Provider Name | SIDNEY RILEY BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 2315 SAN PEDRO DR NE STE F10
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4158
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Country | US
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Telephone | 505-218-6542
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Fax |
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Provider Business Mailing Address
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Address Line | 3985 W 1960 N
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City | LEHI
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State | UT
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Zip | 84048-7031
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Country | US
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Telephone | 505-218-6542
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-64256
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License Number State | UT
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