Individual
CONNIE FRANCES SIDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1528 NW 5TH ST, RICHMOND, IN 47374-1844
(765) 200-6838
Mailing address
1528 NW 5TH ST, RICHMOND, IN 47374-1844
(765) 200-6838
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CII2044
IN
Other
Enumeration date
10/02/2018
Last updated
03/24/2020
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