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Individual

JANET E RILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
1801 SE HILLMOOR DR, SUITE B-105, PORT ST LUCIE, FL 34952-7553
(772) 323-2174
(772) 398-4374
Mailing address
1801 SE HILLMOOR DR, SUITE B-105, PORT ST LUCIE, FL 34952-7553
(772) 323-2174
(772) 398-4374

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A.01627
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AY1580
STATE LICENSE NUMBER
FL
Enumeration date
07/03/2008
Last updated
10/23/2009
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