Provider Demographics
NPI:1801919295
Name:RIEBE, CARRIE ANN
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:RIEBE
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 1:1804 BIRMINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-2518
Mailing Address - Country:US
Mailing Address - Phone:815-474-0765
Mailing Address - Fax:815-556-8543
Practice Address - Street 1:1804 BIRMINGHAM PL
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-2518
Practice Address - Country:US
Practice Address - Phone:815-474-0765
Practice Address - Fax:815-556-8543
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist