Individual
VERASTINE RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
934 43RD ST, KENOSHA, WI 53140-5703
(262) 721-6485
Mailing address
934 43RD ST, KENOSHA, WI 53140-5703
(262) 721-6485
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
0017529
WI
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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