Individual
MRS. 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
4408 FOREST DR STE 102, COLUMBIA, SC 29206-3162
(839) 246-7989
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
12284
SC
101Y00000X
Counselor
9063
SC
101YM0800X
Mental Health Counselor
12284
SC
101YM0800X
Mental Health Counselor
9063
SC
101YP2500X
Professional Counselor
Primary
12284
SC
101YP2500X
Professional Counselor
Primary
9063
SC
Other
Enumeration date
07/14/2025
Last updated
07/02/2026
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