Individual
MARY ELIZABETH RIEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
190 E BANCOCK ST., BOISE, ID 83712
(208) 381-2222
Mailing address
PO BOX 252, PEAPACK, NJ 07977-0252
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00855400
NJ
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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