Individual
MARISA ROSE RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 CLEVELAND AVE, SLIDELL, LA 70458-3920
(985) 643-5746
Mailing address
2919 JACKSON LANDING RD, PICAYUNE, MS 39466-4985
(504) 319-6600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PLC9934
LA
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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