Provider Demographics
NPI:1548591654
Name:RIKE, MARIELLEN DAWN (MA)
Entity Type:Individual
Prefix:MRS
First Name:MARIELLEN
Middle Name:DAWN
Last Name:RIKE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2403
Mailing Address - Country:US
Mailing Address - Phone:720-346-3267
Mailing Address - Fax:
Practice Address - Street 1:107 FIFTH ST.
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-8010
Practice Address - Country:US
Practice Address - Phone:720-346-3267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist