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General NPI Number Information
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NPI Number | 1518335512
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Entity Type | Individual
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Provider Name | RILEY JOBES M.A. CF-SLP
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Gender | Male
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Dates
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Enumeration Date | 09/08/2015
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 7763 NORTHSIDE DR ATTN: RILEY JOBES - SPEECH THERAPY
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420-8944
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Country | US
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Telephone | 843-764-2212
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Fax |
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Provider Business Mailing Address
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Address Line | 1629 MARSH HARBOR LN
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-4569
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Country | US
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Telephone |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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