Provider Demographics
NPI:1053730697
Name:RIDEN, LOIS (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:RIDEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 LAVALLEE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-8815
Mailing Address - Country:US
Mailing Address - Phone:802-434-2342
Mailing Address - Fax:
Practice Address - Street 1:120 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:VT
Practice Address - Zip Code:05462-9795
Practice Address - Country:US
Practice Address - Phone:802-434-2074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist