Individual
MRS. MARYBETH RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CADC
Contact information
Practice address
449 FOREST AVE, SUITE #14, PORTLAND, ME 04101-2029
(207) 400-0157
Mailing address
449 FOREST AVE, SUITE #14, PORTLAND, ME 04101-2029
(207) 400-0157
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC4853
ME
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN63144
ME
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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