Provider Demographics
NPI:1508606500
Name:RIAS, AUDREANA
Entity type:Individual
Prefix:
First Name:AUDREANA
Middle Name:
Last Name:RIAS
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 1:120 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1654
Mailing Address - Country:US
Mailing Address - Phone:740-207-2508
Mailing Address - Fax:740-784-4202
Practice Address - Street 1:225 W EMMITT AVE STE 1
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-1076
Practice Address - Country:US
Practice Address - Phone:740-835-4054
Practice Address - Fax:740-784-4202
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator