Provider Demographics
NPI:1225621519
Name:TOLLIVER COFIELD, RIAH
Entity Type:Individual
Prefix:
First Name:RIAH
Middle Name:
Last Name:TOLLIVER COFIELD
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 1:8091 SW 24TH PL
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-2279
Mailing Address - Country:US
Mailing Address - Phone:954-980-0426
Mailing Address - Fax:
Practice Address - Street 1:8091 SW 24TH PL
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-2279
Practice Address - Country:US
Practice Address - Phone:954-980-0426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst