Provider Demographics
NPI:1528280708
Name:RILEY, KATHLEEN JOAN (MS, CCC-A, FAAA)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:JOAN
Last Name:RILEY
Suffix:
Gender:F
Credentials:MS, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CIRO CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2307
Mailing Address - Country:US
Mailing Address - Phone:302-454-2301
Mailing Address - Fax:302-454-3493
Practice Address - Street 1:620 E CHESTNUT HILL RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1828
Practice Address - Country:US
Practice Address - Phone:320-454-2301
Practice Address - Fax:302-454-3493
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist