Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0119000696 | VA |
NPI | 1003805896 |
---|---|
Provider Name | Cindy K Ridings |
First Address | Gate City, VA 24251-4807 |
Second Address | Gate City, VA 24251-3408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
276163 | BCBS (01) | VA |
4979681 | (05) | VA |