Basic Information
| Provider Information | |||||||||
| NPI: | 1699179697 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIEGER | ||||||||
| FirstName: | KRISTIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2632 NW 41ST ST | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334342515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616340648 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1639 FORUM PL STE 7 | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334012330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617128821 | ||||||||
| FaxNumber: | 5617128070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2014 | ||||||||
| LastUpdateDate: | 10/20/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.