Provider Demographics
NPI:1649744590
Name:RIEPER, VENESSIA BRYANNE
Entity Type:Individual
Prefix:
First Name:VENESSIA
Middle Name:BRYANNE
Last Name:RIEPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 PORTSMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-1818
Mailing Address - Country:US
Mailing Address - Phone:720-822-1094
Mailing Address - Fax:
Practice Address - Street 1:320 WESTWAY PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-5245
Practice Address - Country:US
Practice Address - Phone:817-516-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor