Individual
LISA M. RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD, CCC-A, PASC
Contact information
Practice address
13123 E 16TH AVE, BOX 030, AURORA, CO 80045-7106
(720) 478-0158
Mailing address
13123 E 16TH AVE, BOX 030, AURORA, CO 80045-7106
(720) 478-0158
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
41
CO
237600000X
Audiologist-Hearing Aid Fitter
41
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19282770
—
CO
05
—
69920346
—
CO
Enumeration date
02/17/2007
Last updated
02/06/2017
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