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NPI Code Detail

MEDICARE: STEPHANIE RIEGEL MS

MEDICARE: STEPHANIE RIEGEL MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1073024055
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE RIEGEL MS
Provider Business Mailing Address
First Line : 2644 METRO BLVD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2412
Country : US
Telephone Number : 314-395-9375
Fax Number :
Provider Business Practice Location Address
First Line : 2644 METRO BOULEVARD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2412
Country : US
Telephone Number : 314-395-9375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2017
Last Update Date : 12/04/2018

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