Individual
MRS. CAROLINE M RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
113 MAIN STREET, KIMBERLY, ID 83341
(208) 421-9659
(208) 268-3878
Mailing address
225 MAIN ST N UNIT 182, KIMBERLY, ID 83341-7008
(208) 421-9659
(208) 268-3878
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4298
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201830028
—
ID
Enumeration date
06/10/2020
Last updated
12/16/2021
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