Healthcare Provider Details

I. General information

NPI: 1164964482
Provider Name (Legal Business Name): JENINE F. RIEMER MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2016
Last Update Date: 09/01/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W. BOYD ST.
NORMAN OK
73069-4801
US

IV. Provider business mailing address

2221 DIANA LANE
NORMAN OK
73071-9714
US

V. Phone/Fax

Practice location:
  • Phone: 405-366-7898
  • Fax: 405-366-0010
Mailing address:
  • Phone: 405-510-5248
  • Fax: 405-366-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4059
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: