Individual
MR. JAMES EDWARD REIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
3301 3301 N. BALLARD ROAD, APPLETON, WI 54911-9002
(920) 733-4443
(920) 733-4796
Mailing address
1324 W ELSNER RD, APPLETON, WI 54913-9705
(920) 475-9469
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16389-130
WI
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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