Provider Demographics
NPI:1689233108
Name:RIEBL, EMMA LANGSTON (MS)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:LANGSTON
Last Name:RIEBL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 EAGLE POINTE LOOP
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5982
Mailing Address - Country:US
Mailing Address - Phone:407-923-3303
Mailing Address - Fax:
Practice Address - Street 1:890 N HOUSTON LEVEE RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-6614
Practice Address - Country:US
Practice Address - Phone:844-757-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-08
Last Update Date:2019-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health