Doctor Name: | ANITA ANN RISDON |
NPI Number: | 1326255548 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | 22003966A |
Business Practice Address: | 2605 N Lebanon St Lebanon, IN - 460521476 |
Business Phone Number: | 7654837320 |
Business Fax Number: | |
Mailing Address: | 2605 N Lebanon St, LEBANON |
State: | IN |
Postal Code: | 460521476 |
Phone Number: | 7654837320 |
Fax Number: | |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22003966A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |