Individual
KRISTINE RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
6400 UPTOWN BLVD NE, MEDICAID OFFICE, ALBUQUERQUE, NM 87110-4204
(505) 880-3700
Mailing address
1100 SOLAR RD NW # 87107, ALBUQUERQUE, NM 87107-5754
(505) 344-4412
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
048
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000L7428
—
NM
Enumeration date
01/15/2007
Last updated
07/09/2007
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