Individual
JUSTICE RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4643 WADSWORTH BLVD, WHEAT RIDGE, CO 80033-3305
(303) 425-4480
(614) 355-8593
Mailing address
4851 INDEPENDENCE ST, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09929582
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
06/04/2020
Last updated
04/24/2024
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