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Individual

TARA LYN RILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
75-127 LUNAPULE ROAD, #11, KAILUA KONA, HI 96740
(808) 326-7778
(808) 326-4063
Mailing address
75-5851 KUAKINI HWY, #34, KAILUA KONA, HI 63740
(429) 842-7161
(479) 521-5439

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-947
HI
225XP0200X
Pediatric Occupational Therapist
OTR1131
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130525721
AR
01
5T431
AR BLUE CROSS BLUE SHEILD
Enumeration date
01/22/2007
Last updated
02/23/2016
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