Individual
GLORIA NICOLE RIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 S 2ND ST STE 180, MINNEAPOLIS, MN 55454-5000
(612) 625-1562
(612) 626-8311
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP6267
MN
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/26/2010
Last updated
07/02/2018
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