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NPI Code Detail

MEDICARE: RILEY M SPETH

MEDICARE: RILEY M SPETH
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 Technician
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1932753746
Entity Type Code : Individual
Provider Name (Legal Business Name) : RILEY M SPETH
Provider Business Mailing Address
First Line : 515 S 700 E STE 2A
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-2855
Country : US
Telephone Number : 800-434-8923
Fax Number :
Provider Business Practice Location Address
First Line : 440 S 500 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-2705
Country : US
Telephone Number : 801-359-8862
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2019
Last Update Date : 09/09/2021

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Directions to “ RILEY M SPETH ” Practice Location

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