| Organization Name: | NANCY RIETDORF PHD PLLC |
| NPI Number: | 1245383736 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY A RIETDORF (PRESIDENT) |
| Mailing Address: | 2837 Stable Dr Suite B Kimball |
| State: | MI US |
| Postal Code: | 480741441 |
| Phone Number: | 8109858000 |
| Fax Number: | 8109858044 |
| NPI Enumeration Date: | 01/19/2007 |
| NPI Last Update Date: | 11/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301004023 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |