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Individual

DANA M RIDEOUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
410 UNIVERSITY PKWY., SUITE 2300, AIKEN, SC 29801-6807
(803) 335-1219
(803) 335-1689
Mailing address
410 UNIVERSITY PKWY, SUITE 2300, AIKEN, SC 29801-6807
(803) 335-1219
(803) 335-1689

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5516
SC
101YP2500X
Professional Counselor
5516
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PC1382
SC
Enumeration date
05/06/2013
Last updated
02/03/2015
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