Provider Demographics
NPI:1538947411
Name:RITZINGER, KIELEY J
Entity type:Individual
Prefix:
First Name:KIELEY
Middle Name:J
Last Name:RITZINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIELEY
Other - Middle Name:J
Other - Last Name:VANBEEKUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:283 E 300 S
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-2258
Mailing Address - Country:US
Mailing Address - Phone:801-897-5604
Mailing Address - Fax:801-992-8508
Practice Address - Street 1:283 E 300 S
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-2258
Practice Address - Country:US
Practice Address - Phone:801-897-5604
Practice Address - Fax:801-992-8508
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician