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General NPI Number Information
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NPI Number | 1992404339
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Entity Type | Individual
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Provider Name | MR. RILEY ALEXANDER WALSH
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Gender | Male
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 2211 E HIGHLAND AVE STE 205
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City | PHOENIX
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State | AZ
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Zip | 85016-4834
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Country | US
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Telephone | 480-349-3671
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Fax |
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Provider Business Mailing Address
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Address Line | 5120 E HAMPTON AVE APT 1073
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City | MESA
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State | AZ
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Zip | 85206-6794
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Country | US
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Telephone | 404-723-4709
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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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