Provider Demographics
NPI:1518507508
Name:RIEPE, KLARYSA EVA (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:KLARYSA
Middle Name:EVA
Last Name:RIEPE
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8610 WOODLEDGE LN
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-3573
Mailing Address - Country:US
Mailing Address - Phone:704-900-9817
Mailing Address - Fax:
Practice Address - Street 1:8610 WOODLEDGE LN
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3573
Practice Address - Country:US
Practice Address - Phone:704-900-9817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool