Provider Demographics
NPI:1841362613
Name:RIEL, KRISTEN (MA)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:RIEL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 DRESSER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-9160
Mailing Address - Country:US
Mailing Address - Phone:608-752-7255
Mailing Address - Fax:
Practice Address - Street 1:4700 DRESSER DR STE 100
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-9160
Practice Address - Country:US
Practice Address - Phone:608-752-7255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health