Individual
ANN REIDENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH RD CD
Contact information
Practice address
6522 CONSTITUTION DR, FORT WAYNE, IN 46804-1550
(260) 433-3877
(260) 755-5731
Mailing address
6522 CONSTITUTION DR, FORT WAYNE, IN 46804-1550
(260) 433-3877
(260) 755-5731
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37000578A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922377423
NPI , ORGANIZATIONAL ENTITY
—
Enumeration date
09/13/2005
Last updated
01/23/2012
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