Provider Demographics
NPI:1407388101
Name:RIES, CHRISTINE (BA, CADC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:RIES
Suffix:
Gender:F
Credentials:BA, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:IA
Mailing Address - Zip Code:52208-1203
Mailing Address - Country:US
Mailing Address - Phone:641-745-9664
Mailing Address - Fax:641-484-9477
Practice Address - Street 1:702 17TH ST
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:IA
Practice Address - Zip Code:52208-1203
Practice Address - Country:US
Practice Address - Phone:641-745-9664
Practice Address - Fax:641-745-9664
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16054101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)