Individual
AYSIA RIEWALDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4124 ODIE LN, SANTA MARIA, CA 93455-3109
(805) 714-4651
Mailing address
1109 W NECTARINE AVE, LOMPOC, CA 93436-4321
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/21/2018
Last updated
12/16/2024
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