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General NPI Number Information
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NPI Number | 1366158750
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Entity Type | Individual
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Provider Name | CLARE MARIE RILEY BA
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Gender | Female
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 7601 WAYZATA BLVD
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City | ST LOUIS PARK
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State | MN
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Zip | 55426-1626
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Country | US
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Telephone | 612-223-8898
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Fax |
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Provider Business Mailing Address
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Address Line | 6575 PHEASANT RUN S
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City | LINO LAKES
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State | MN
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Zip | 55014-1496
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Country | US
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Telephone | 651-900-5733
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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