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Individual

KELLY WARDEN RIEKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(623) 772-4090
Mailing address
14624 S 179TH AVE, GOODYEAR, AZ 85338-7790
(602) 642-6741

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CW016412
PA
1041C0700X
Clinical Social Worker
Primary
I.0800377
OH
1041C0700X
Clinical Social Worker
LCSW-15557
AZ

Other

Enumeration date
11/16/2010
Last updated
10/04/2022
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