NPI | 1013055995 |
---|---|
Former Name | MARI ELIZABETH RILEY-KRESGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01219) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T0523) |
Enumeration Date | 2007-02-02 |
Last Update Date | 2016-05-19 |