Individual
MS. AMANDA MICHELLE RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
3715 N BUSINESS DR, STE 104, FAYETTEVILLE, AR 72703-5204
(479) 521-1532
(479) 521-9940
Mailing address
2153 E JOYCE BLVD, STE 201, FAYETTEVILLE, AR 72703-4714
(479) 575-9471
(479) 587-9392
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194359740
—
AR
Enumeration date
04/19/2011
Last updated
05/20/2016
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