Provider Demographics
NPI:1407383185
Name:WALKER-RILEY, TIFPHANE
Entity Type:Individual
Prefix:
First Name:TIFPHANE
Middle Name:
Last Name:WALKER-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 1:2521 MARKHAM LN
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2602
Mailing Address - Country:US
Mailing Address - Phone:267-307-9804
Mailing Address - Fax:
Practice Address - Street 1:1320 19TH ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1637
Practice Address - Country:US
Practice Address - Phone:202-629-1949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist