Provider Demographics
NPI:1720859952
Name:RILEY, ZOE OLIVIA (BCBA)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:OLIVIA
Last Name:RILEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 RIVER DR S APT 2102
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-2728
Mailing Address - Country:US
Mailing Address - Phone:248-821-1018
Mailing Address - Fax:
Practice Address - Street 1:35 RIVER DR S APT 2102
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-2728
Practice Address - Country:US
Practice Address - Phone:248-821-1018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002509103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst