| Doctor Name: | MRS. MANDEE L RIDDELL |
| NPI Number: | 1053459826 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | AU.D. |
| License Number: | 0469 |
| Business Practice Address: | 7575 Us Highway 42 Florence, KY - 410421939 |
| Business Phone Number: | 8592836044 |
| Business Fax Number: | 8592836046 |
| Mailing Address: | 40 N Grand Ave, Suite 100 FORT THOMAS |
| State: | KY |
| Postal Code: | 410754107 |
| Phone Number: | 8595724103 |
| Fax Number: | 8595723044 |
| NPI Enumeration Date: | 02/02/2007 |
| NPI Last Update Date: | 08/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 0469 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |