Individual
DR. ROBERT D RIESKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
921 S 8TH AVE STOP 8112, POCATELLO, ID 83209-8112
(208) 282-4192
Mailing address
921 S 8TH AVE STOP 8112, POCATELLO, ID 83209-8112
(208) 282-4192
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-203041
ID
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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