Individual
MR. KENNETH CHARLES RIDEOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. ED.
Contact information
Practice address
321 EAST 5TH AVENUE, TARENTUM, PA 15208
(724) 226-0664
(724) 226-4865
Mailing address
321 EAST 5TH AVENUE, TARENTUM, PA 15208
(724) 226-0664
(724) 226-4865
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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