Individual
MRS. BONNIE D. RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP, LPC
Contact information
Practice address
17244 DOYLE RD, BOONVILLE, MO 65233-3500
(660) 882-2377
Mailing address
17244 DOYLE RD, BOONVILLE, MO 65233-3500
(660) 882-6400
(660) 882-7137
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
000538
MO
103T00000X
Psychologist
Primary
01427
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493221105
—
MO
01
—
6136915
UNITED BEHAVIORAL HEALTH
MO
Enumeration date
12/13/2006
Last updated
01/05/2022
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