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General NPI Number Information
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NPI Number | 1427502632
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Entity Type | Individual
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Provider Name | SUZANNE RILEY MSW
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Gender | Female
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Dates
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Enumeration Date | 08/05/2016
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Last Update Date | 08/05/2016
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Provider Practice Location Address
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Address Line | 116 HILLS PLZ
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City | CHARLESTON
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State | WV
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Zip | 25387-2438
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Country | US
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Telephone | 304-720-4466
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Fax | 304-720-4813
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Provider Business Mailing Address
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Address Line | 97 GREAT TEAYS BLVD SUITE 6
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City | SCOTT DEPOT
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State | WV
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Zip | 25560-9815
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Country | US
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Telephone | 304-757-6999
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Fax | 304-757-3252
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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 | AP00200005
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License Number State | WV
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