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Individual

MR. JAMES EDWIN RILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1025 WAGON TRAIL LN, GOLDSBY, OK 73093-9153
(405) 288-2611
Mailing address
1025 WAGON TRAIL LN, GOLDSBY, OK 73093-9153
(405) 288-2611

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
3484
OK
1041C0700X
Clinical Social Worker
Primary
3953
OK

Other

Enumeration date
11/01/2007
Last updated
01/12/2012
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