Individual
LISA RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 HIGHLAND MEADOWS CIR STE 4, HIGHLAND HEIGHTS, KY 41076-3717
(513) 354-5200
Mailing address
25 HIGHLAND MEADOWS CIR STE 4, HIGHLAND HEIGHTS, KY 41076-3717
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDC.151098-3
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCDC.151098-3
LICENSURE
OH
Enumeration date
11/03/2017
Last updated
11/03/2017
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