Provider Demographics
NPI:1285107144
Name:RIFFLE, KATHERYNE
Entity type:Individual
Prefix:
First Name:KATHERYNE
Middle Name:
Last Name:RIFFLE
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 1:1345 E HENRI DE TONTI BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:TONTITOWN
Mailing Address - State:AR
Mailing Address - Zip Code:72762-5347
Mailing Address - Country:US
Mailing Address - Phone:315-402-6427
Mailing Address - Fax:479-595-8969
Practice Address - Street 1:1345 E HENRI DE TONTI BLVD STE C
Practice Address - Street 2:
Practice Address - City:TONTITOWN
Practice Address - State:AR
Practice Address - Zip Code:72762-5347
Practice Address - Country:US
Practice Address - Phone:479-633-7547
Practice Address - Fax:479-595-8969
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health