Provider Demographics
NPI:1073717021
Name:RIDLEHUBER, JANEL MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:MARIE
Last Name:RIDLEHUBER
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:PO BOX 162904
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-2904
Mailing Address - Country:US
Mailing Address - Phone:512-306-1707
Mailing Address - Fax:513-306-7380
Practice Address - Street 1:4613 BEE CAVE RD STE 202
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5212
Practice Address - Country:US
Practice Address - Phone:512-306-1707
Practice Address - Fax:512-306-7380
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24945235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX24945OtherSTATE BOARD