Provider Demographics
NPI:1699250761
Name:RILEY, CAROLE K
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:K
Last Name:RILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 PLEASANT ST APT 10
Mailing Address - Street 2:
Mailing Address - City:EAST WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02032-1208
Mailing Address - Country:US
Mailing Address - Phone:617-827-6814
Mailing Address - Fax:
Practice Address - Street 1:144 PLEASANT ST APT 10
Practice Address - Street 2:
Practice Address - City:EAST WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02032-1208
Practice Address - Country:US
Practice Address - Phone:617-827-6814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical