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Individual
DANA M RIDEOUT
Active
Individual
DANA M RIDEOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5516
SC
101YP2500X
Professional Counselor
5516
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1382
—
SC
Enumeration date
05/06/2013
Last updated
02/03/2015
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