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Individual

MS. BONNIE JEAN RILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
18564 US ROUTE 11, WATERTOWN, NY 13601-5900
(315) 783-5386
Mailing address
18564 US ROUTE 11, WATERTOWN, NY 13601-5900
(315) 783-5386

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R069336-1
NY

Other

Enumeration date
12/15/2005
Last updated
10/07/2008
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