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General NPI Number Information
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NPI Number | 1346010014
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Entity Type | Individual
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Provider Name | GENOVIA C RILEY LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 9106 PHILADELPHIA RD STE 208
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City | ROSEDALE
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State | MD
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Zip | 21237-4333
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Country | US
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Telephone | 443-530-6921
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Fax |
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Provider Business Mailing Address
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Address Line | 4242 SUITLAND RD APT 203
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City | SUITLAND
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State | MD
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Zip | 20746-2053
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Country | US
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Telephone | 301-683-8590
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 28674
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License Number State | MD
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