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Individual

DEIDRA NICOLE RILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4408 FOREST DR STE 102, COLUMBIA, SC 29206-3162
(949) 282-9667
Mailing address
712 STERLING CREEK CT, LEXINGTON, SC 29072-9824
(949) 282-9667

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
9063
SC
101YM0800X
Mental Health Counselor
9063
SC
101YP2500X
Professional Counselor
Primary
9063
SC

Other

Enumeration date
07/14/2025
Last updated
09/05/2025
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