Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1083383046 |
---|---|
Provider Name | Molly Riley |
First Address | Denver, CO 80221-6414 |
Second Address | Denver, CO 80221-6414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2021 |
Last Update Date | 12/09/2021 |