Provider Demographics
NPI:1104070069
Name:RIKER, MARLYNN ANNETTE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARLYNN
Middle Name:ANNETTE
Last Name:RIKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 ROAD 9 1/2
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-9254
Mailing Address - Country:US
Mailing Address - Phone:307-754-7970
Mailing Address - Fax:307-754-7971
Practice Address - Street 1:2538 BIG HORN AVE
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-9299
Practice Address - Country:US
Practice Address - Phone:307-587-2197
Practice Address - Fax:307-527-6218
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW #2891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical