Individual
DR. RONALD J RIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1251
(319) 369-4777
(319) 369-4694
Mailing address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1251
(319) 369-4777
(319) 369-4694
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
080046
IA
103TC0700X
Clinical Psychologist
PHD338
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025567800
—
NE
05
—
10025845100
—
NE
01
—
NA1614
PTAN GROUP
NE
01
—
NA1614001
INDIVIDUAL PTAN
NE
Enumeration date
01/31/2006
Last updated
12/15/2015
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