Provider Demographics
NPI:1235374653
Name:RIETZ, PAULA KAY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:KAY
Last Name:RIETZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 BUR OAK DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5986
Mailing Address - Country:US
Mailing Address - Phone:816-680-8399
Mailing Address - Fax:
Practice Address - Street 1:12700 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2033
Practice Address - Country:US
Practice Address - Phone:972-573-1010
Practice Address - Fax:972-233-1099
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical