Provider Demographics
NPI:1659645844
Name:RILEY, SONIA GRIFFIN (RN)
Entity type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:GRIFFIN
Last Name:RILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 GLADYS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-8202
Mailing Address - Country:US
Mailing Address - Phone:409-860-9111
Mailing Address - Fax:
Practice Address - Street 1:8109 GLADYS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-8202
Practice Address - Country:US
Practice Address - Phone:409-860-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671328175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath