Doctor Name: | MRS. EMILY BANKS RIEGEL |
NPI Number: | 1043467582 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. , L.M.H.C. |
License Number: | MH3390 |
Business Practice Address: | 1538 The Greens Way Suite 101 Jacksonville Beach, FL - 322502499 |
Business Phone Number: | 9045430161 |
Business Fax Number: | 9045439172 |
Mailing Address: | 1538 The Greens Way, Suite 101 JACKSONVILLE BEACH |
State: | FL |
Postal Code: | 322502499 |
Phone Number: | 9045430161 |
Fax Number: | 9045439172 |
NPI Enumeration Date: | 08/27/2008 |
NPI Last Update Date: | 08/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH3390 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |