Provider Demographics
NPI:1750371696
Name:RIFNER, LOIS JEAN (PHD, HSPP)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:JEAN
Last Name:RIFNER
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-0213
Mailing Address - Country:US
Mailing Address - Phone:812-279-8651
Mailing Address - Fax:812-275-6520
Practice Address - Street 1:1702 C ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-4316
Practice Address - Country:US
Practice Address - Phone:812-279-8651
Practice Address - Fax:812-275-6520
Is Sole Proprietor?:No
Enumeration Date:2005-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20010326103TH0100X
IN103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN55821OtherCIGNA BEHAVIORAL HEALTH
IN000000195283OtherANTHEM BCBS
IN0004351156OtherAETNA
IN55821OtherCIGNA BEHAVIORAL HEALTH