Provider Demographics
NPI:1457750945
Name:RIEGEL, MARY KATHRYN (MSW LSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KATHRYN
Last Name:RIEGEL
Suffix:
Gender:F
Credentials:MSW LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:589 COVENTRY CT
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-1646
Mailing Address - Country:US
Mailing Address - Phone:610-730-7132
Mailing Address - Fax:610-262-1462
Practice Address - Street 1:589 COVENTRY CT
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18067-1646
Practice Address - Country:US
Practice Address - Phone:610-730-7132
Practice Address - Fax:610-262-1462
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW011184104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker