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NPI Code Detail

MEDICARE: RIANA CLARK

MEDICARE: RIANA CLARK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-25-403377NC

General Provider Information

NPI Number : 1568324382
Entity Type Code : Individual
Provider Name (Legal Business Name) : RIANA CLARK
Provider Business Mailing Address
First Line : 1216 MANN DR
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-5512
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1216 MANN DR
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-5512
Country : US
Telephone Number : 800-244-4691
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “ RIANA CLARK ” Practice Location

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