Riddle, Amanda Michelle

Riddle, Amanda Michelle is an individual health care provider with primary practice located at 3715 N Business Dr Ste 104, Fayetteville AR 72703-5204. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Riddle, Amanda Michelle can be contacted via phone (479) 521-1532.

Contact Information

Primary practice address
3715 N Business Dr Ste 104 Fayetteville AR 72703-5204
Phone: (479) 521-1532
Fax: (479) 521-9940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1528358975
LBN Legal business name Riddle, Amanda Michelle
Credentials CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2011
Last updated May 20th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528358975 NPPES
Arkansas MEDICAID 194359740

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