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General NPI Number Information
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NPI Number | 1316348865
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Entity Type | Individual
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Provider Name | LAMIKA RILEY
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Gender | Female
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 18320 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48219-4162
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Country | US
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Telephone | 313-622-8286
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Fax |
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Provider Business Mailing Address
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Address Line | 18452 SCHAEFER HWY
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City | DETROIT
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State | MI
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Zip | 48235
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Country | UM
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Telephone | 313-622-8286
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | MI
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