Individual
AMANDA ANNE RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 W GANSON ST, JACKSON, MI 49202-4208
(517) 500-4981
Mailing address
1111 W GANSON ST, JACKSON, MI 49202-4208
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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