Individual
MS. WILLETTE RILEY
Active
Individual
MS. WILLETTE RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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