Provider Demographics
NPI:1215151337
Name:RIEGERT, ELEANOR (PSYD)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:RIEGERT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 PROVIDENCE RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2206
Mailing Address - Country:US
Mailing Address - Phone:919-403-6581
Mailing Address - Fax:
Practice Address - Street 1:180 PROVIDENCE RD
Practice Address - Street 2:SUITE 9
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2206
Practice Address - Country:US
Practice Address - Phone:919-812-1622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1934103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent