Provider Information for 1477064699
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MORIAH LYNNE KREPPEIN RIQUELME LCSW
Sex: Female
NPI: 1477064699
Last Updated: 2024-09-30
Certification Date: 2024-09-30
Certification Date: 2024-09-30
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1477064699 | ||||||||||||||||
| Enumeration Date | 2017-10-15 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 8315 98TH ST APT 2C WOODHAVEN, NY 11421-8400 United States Phone: 347-637-0375 | Fax: | ||||||||||||||||
| Primary Practice Address | 8315 98TH ST APT 2C WOODHAVEN, NY 11421-8400 United States Phone: 347-637-0375 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 407 COLLINS ST | ||||||||||||||||
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