Provider Demographics
NPI:1417195520
Name:RIEFKOHL, ROXANNE MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:MARIE
Last Name:RIEFKOHL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ROXY
Other - Middle Name:MARIE
Other - Last Name:RIEFKOHL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:11999 KATY FWY
Mailing Address - Street 2:STE 490
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1611
Mailing Address - Country:US
Mailing Address - Phone:713-365-0700
Mailing Address - Fax:
Practice Address - Street 1:11999 KATY FWY
Practice Address - Street 2:STE 490
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1611
Practice Address - Country:US
Practice Address - Phone:713-365-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YS0200X
TX68735101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool