Provider Demographics
NPI:1053097303
Name:WOHLRAB, RILEY
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:WOHLRAB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RILEY
Other - Middle Name:
Other - Last Name:WOHLRAB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 MAINE ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1396
Mailing Address - Country:US
Mailing Address - Phone:785-832-8192
Mailing Address - Fax:785-843-2219
Practice Address - Street 1:200 MAINE ST STE A
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1396
Practice Address - Country:US
Practice Address - Phone:785-832-8192
Practice Address - Fax:785-843-2219
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13131104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker