Individual
DR. KEITH LEE RIEDER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
1061 MAPLE DR, SUITE 1, MORGANTOWN, WV 26505-2814
(304) 599-5751
(304) 599-2124
Mailing address
1061 MAPLE DR, SUITE 1, MORGANTOWN, WV 26505-2814
(304) 599-5751
(304) 599-2124
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
580
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164008000
—
WV
01
—
047096
VALUE OPTIONS
WV
01
—
Y295240
MAGELLAN/HEALTH PLAN
WV
Enumeration date
02/22/2006
Last updated
07/08/2007
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