Individual
RETTA LYNN RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 SAN PEDRO DR NE # 118, ALBUQUERQUE, NM 87110-4131
(505) 463-1970
Mailing address
5915 MAHONEY LN, ALBUQUERQUE, NM 87107-4954
(505) 463-1970
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CBT-2024-0721
NM
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72129859
—
NM
Enumeration date
06/22/2017
Last updated
08/05/2025
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