Provider Demographics
NPI:1639916612
Name:RIEKE, ALEXANDRA (MS)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:RIEKE
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 1:4645 NORMAL BLVD STE 272
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5823
Mailing Address - Country:US
Mailing Address - Phone:402-665-0596
Mailing Address - Fax:
Practice Address - Street 1:4645 NORMAL BLVD STE 272
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5823
Practice Address - Country:US
Practice Address - Phone:402-665-0596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health