Provider Demographics
NPI:1932453388
Name:HINDBAUGH, RONALD (MA)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:HINDBAUGH
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2376 WILDWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1657
Mailing Address - Country:US
Mailing Address - Phone:734-944-3446
Mailing Address - Fax:866-223-1175
Practice Address - Street 1:403 N BROAD ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2127
Practice Address - Country:US
Practice Address - Phone:734-944-3446
Practice Address - Fax:866-223-1175
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401000667101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health