Provider Demographics
NPI:1740053297
Name:RILEY, DAYZAH (RBT, BA)
Entity type:Individual
Prefix:MS
First Name:DAYZAH
Middle Name:
Last Name:RILEY
Suffix:
Gender:F
Credentials:RBT, BA
Other - Prefix:
Other - First Name:DAYZAH
Other - Middle Name:
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105B CHAUCER RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3132
Mailing Address - Country:US
Mailing Address - Phone:609-531-3964
Mailing Address - Fax:
Practice Address - Street 1:4 MILL RUN CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2436
Practice Address - Country:US
Practice Address - Phone:609-953-5793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician