Provider Demographics
NPI:1184482481
Name:O'BRIEN, RILEIGH (MA SLP)
Entity type:Individual
Prefix:
First Name:RILEIGH
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5011 KOHLER RD
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18092-2066
Mailing Address - Country:US
Mailing Address - Phone:610-509-2241
Mailing Address - Fax:
Practice Address - Street 1:34 BOW ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:NH
Practice Address - Zip Code:03263-3421
Practice Address - Country:US
Practice Address - Phone:603-435-8432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL017900235Z00000X
MEST3931235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist