Individual
FREDERICK RYAN RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
406 WEST JORDAN RIVER PARKWAY, SUITE 220, SOUTH JORDAN, UT 84065-4321
(801) 891-8281
Mailing address
14187 TEMPEST RIDGE CIR, HERRIMAN, UT 84096-1873
(801) 891-8281
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4788890-3501
UT
Other
Enumeration date
05/02/2007
Last updated
11/17/2008
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