Individual
RILEY CORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPCC
Contact information
Practice address
2214 5TH AVE, SAN DIEGO, CA 92101-2104
(619) 512-3545
Mailing address
2214 5TH AVE, SAN DIEGO, CA 92101-2104
(619) 512-3545
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
18
CA
Other
Enumeration date
03/18/2008
Last updated
10/23/2014
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