Provider Demographics
NPI:1992289797
Name:RIESZ, GABRIELA RUTH (LICSW)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:RUTH
Last Name:RIESZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2713
Mailing Address - Country:US
Mailing Address - Phone:413-320-0644
Mailing Address - Fax:
Practice Address - Street 1:37 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-2713
Practice Address - Country:US
Practice Address - Phone:413-320-0644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10230241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical