Provider Demographics
NPI:1457149734
Name:RILEY, NOELLE VIVIAN
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:VIVIAN
Last Name:RILEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7208 PINEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-2994
Mailing Address - Country:US
Mailing Address - Phone:937-580-4604
Mailing Address - Fax:
Practice Address - Street 1:7208 PINEWOOD DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-2994
Practice Address - Country:US
Practice Address - Phone:937-580-4604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician