Provider Demographics
NPI:1316062987
Name:RIEHM, TINA R
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:R
Last Name:RIEHM
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 1:5839 MACKEREL RD
Mailing Address - Street 2:
Mailing Address - City:BOKEELIA
Mailing Address - State:FL
Mailing Address - Zip Code:33922-2824
Mailing Address - Country:US
Mailing Address - Phone:239-560-1997
Mailing Address - Fax:239-433-6706
Practice Address - Street 1:5839 MACKEREL RD
Practice Address - Street 2:
Practice Address - City:BOKEELIA
Practice Address - State:FL
Practice Address - Zip Code:33922-2824
Practice Address - Country:US
Practice Address - Phone:239-560-1997
Practice Address - Fax:239-433-6706
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker