Provider Demographics
NPI:1053682492
Name:RILEY, JULIE (LPC, ATR)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:RILEY
Suffix:
Gender:F
Credentials:LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 5TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-1914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5610 5TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-1914
Practice Address - Country:US
Practice Address - Phone:281-896-4342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65695101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional