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General NPI Number Information
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NPI Number | 1265378921
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Entity Type | Individual
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Provider Name | RILEY MOYLE LLMSW
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Gender | Male
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 5228 LOVERS LN STE 102
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City | PORTAGE
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State | MI
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Zip | 49002-1521
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Country | US
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Telephone | 269-993-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 26780 COUNTY ROAD 364
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City | MATTAWAN
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State | MI
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Zip | 49071-9557
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Country | US
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Telephone | 269-993-0350
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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