Individual
TANYA NICHOLLE RIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1747 23RD ST SE, ROCHESTER, MN 55904-5845
(507) 358-1220
Mailing address
1747 23RD ST SE, ROCHESTER, MN 55904-5845
(507) 513-0588
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC939
MN
Other
Enumeration date
01/07/2015
Last updated
03/28/2022
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