Individual
MRS. MARY KAY RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
189 W CLARKSTON RD BLDG B, LAKE ORION, MI 48362-2892
(248) 568-6401
Mailing address
189 W CLARKSTON RD STE 210, LAKE ORION, MI 48362-2892
(248) 568-6401
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401012077
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1883825
—
MI
Enumeration date
09/10/2009
Last updated
04/18/2022
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