Provider Demographics
NPI:1538481213
Name:RIABIKINA, IRINA NICOLAEVNA (ND)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:NICOLAEVNA
Last Name:RIABIKINA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:IRINA
Other - Middle Name:NICOLAEVNA
Other - Last Name:DOTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4500 N 32ND ST
Mailing Address - Street 2:STE 116
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3396
Mailing Address - Country:US
Mailing Address - Phone:480-310-9893
Mailing Address - Fax:480-212-9812
Practice Address - Street 1:4500 N 32ND ST
Practice Address - Street 2:STE 116
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3396
Practice Address - Country:US
Practice Address - Phone:480-310-9893
Practice Address - Fax:480-212-9812
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ09-1155175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath