Individual
DR. ROBERT G. RIEDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7830 BELMONT DR, LAKE WORTH, FL 33467-7828
(320) 491-1376
Mailing address
7830 BELMONT DR, LAKE WORTH, FL 33467-7828
(320) 491-1376
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
LP0626
MN
103TF0200X
Forensic Psychologist
Primary
LP0626
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063L4RI
BLUE SHIELD OF MINNESOTA
MN
01
—
1042326
PREFERREDONE
MN
05
—
531347300
—
MN
Enumeration date
06/22/2006
Last updated
08/10/2011
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