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Individual

MICHAEL J RIDDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPCC

Contact information

Practice address
2450 ALAMO AVE SE, ALBUQUERQUE, NM 87106-3204
(505) 925-2400
Mailing address
2450 ALAMO AVE SE, ALBUQUERQUE, NM 87106-3204
(505) 883-0837

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5675
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42384575
NM
Enumeration date
01/12/2006
Last updated
06/11/2012
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