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Individual

DR. MICHELLE ELIZABETH RIDENOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D

Contact information

Practice address
24 N SAINT JOSEPH AVE, SUITE C-1, NILES, MI 49120-2263
(269) 683-0800
(269) 683-7638
Mailing address
24 N SAINT JOSEPH AVE, SUITE C-1, NILES, MI 49120-2263
(269) 683-0800
(269) 683-7638

Taxonomy

Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
L1853937
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L1853937
STATE OF MICHIGAN DEPT OF COMMUNITY HEALTH LICENSE
MI
Enumeration date
10/26/2010
Last updated
10/26/2010
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