Randall Rider's National Provider Identifier (NPI) Details
Randall Rider, MS, LSW, LMFT
NPI: 1982737722
Enumeration Date: 2007-03-13
Last updated: 2007-07-08
Sole Proprietor: YES
Status: active
Postal Address: 3535 MAXIM DR, FORT WAYNE, IN
Phone: 260-312-0904
Primary Practice Address: 4235 FLAGSTAFF COVE, FORT WAYNE, IN
Practice's phone: 260-969-6600