Dr. Jonathan Michael Ridenour, PSYD
Psychologist in Tyler, TX. Individual provider (NPI-1).
NPI number1760703003
StatusActive
Last updated in NPPESSep 18, 2023
Details
- NPI
- 1760703003
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jonathan Michael Ridenour
- Credential
- PSYD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 22, 2010
- Certification date
- Sep 18, 2023
- Last updated
- Sep 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 34806 | TX | Yes |
Practice location
4801 Troup Hwy Ste 502Tyler, TX 75703-2357
Phone 903-630-5788 · Fax 903-630-5885
Mailing address
4801 Troup Hwy Ste 502Tyler, TX 75703-2357
Phone 903-630-5788 · Fax 903-630-5885
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All 21 Psychologist providers in Tyler · All 6,843 providers in Tyler
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