Provider Demographics
NPI:1285829127
Name:RIESENBERG, SHEILA SUE (CRC)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:SUE
Last Name:RIESENBERG
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2425
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-2425
Mailing Address - Country:US
Mailing Address - Phone:406-205-4656
Mailing Address - Fax:888-419-8818
Practice Address - Street 1:1215 10TH AVE SW
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-3103
Practice Address - Country:US
Practice Address - Phone:406-205-4656
Practice Address - Fax:888-419-8818
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor