Individual
MRS. JACKIE M RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4963 US 30, SUITE 204, GREENSBURG, PA 15601
(724) 610-7724
Mailing address
4963 US 30, SUITE 204, GREENSBURG, PA 15601
(724) 610-7724
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC001495
PA
Other
Enumeration date
04/02/2021
Last updated
04/02/2021
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