Provider Demographics
NPI:1548601701
Name:RILEY, TONYA N
Entity type:Individual
Prefix:MS
First Name:TONYA
Middle Name:N
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 1:210 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-1115
Mailing Address - Country:US
Mailing Address - Phone:937-852-6256
Mailing Address - Fax:937-852-6395
Practice Address - Street 1:210 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140
Practice Address - Country:US
Practice Address - Phone:937-852-6256
Practice Address - Fax:937-852-6395
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator