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Individual

DEANA RILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.C., C.P.C.S.

Contact information

Practice address
130 GOVERNORS SQ STE B, PEACHTREE CITY, GA 30269-4862
(770) 713-8023
Mailing address
130 GOVERNORS SQ STE B, PEACHTREE CITY, GA 30269-4862
(770) 451-0404

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002029
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1457876906
THE CENTER FOR LIVING BALANCE
GA
01
55-0872146
FEDERAL TAX ID
GA
Enumeration date
10/06/2006
Last updated
01/27/2020
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