Provider Demographics
NPI:1710154802
Name:RILLING, CORRIE (SLP)
Entity Type:Individual
Prefix:MS
First Name:CORRIE
Middle Name:
Last Name:RILLING
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 S MARYLAND PKWY
Mailing Address - Street 2:STE A-5 #264
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-7146
Mailing Address - Country:US
Mailing Address - Phone:702-985-8385
Mailing Address - Fax:
Practice Address - Street 1:9937 DELICATE DEW ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-7153
Practice Address - Country:US
Practice Address - Phone:702-985-8385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1264235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist