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General NPI Number Information
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NPI Number | 1124971866
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Entity Type | Individual
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Provider Name | COLE MICHAEL RIDDLE
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Gender | Male
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 3285 MARTIN RD STE 104
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City | COMMERCE TOWNSHIP
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State | MI
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Zip | 48390-1601
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Country | US
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Telephone | 248-289-3008
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Fax |
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Provider Business Mailing Address
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Address Line | 11387 IZIKS WAY
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City | BRIGHTON
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State | MI
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Zip | 48116-6601
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Country | US
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Telephone | 810-844-6957
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | MI
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