Provider Demographics
NPI:1538371836
Name:RICHIED, DEBRA D (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:D
Last Name:RICHIED
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5421 KIETZKE LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3027
Mailing Address - Country:US
Mailing Address - Phone:775-853-1314
Mailing Address - Fax:775-853-1277
Practice Address - Street 1:5421 KIETZKE LN
Practice Address - Street 2:SUITE 101
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3027
Practice Address - Country:US
Practice Address - Phone:775-853-1314
Practice Address - Fax:775-853-1277
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY240103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002616036Medicaid
NV002616036Medicaid