Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 6301005762 | MI |
NPI | 1063562429 |
---|---|
Provider Name | Mrs. Debra Kay Riedinger |
First Address | Midland, MI 48640-5470 |
Second Address | Midland, MI 48640-5470 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 08/07/2007 |