Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 5464 | OH |
Y | 103G00000X | Clinical Psychologist | 5464 | OH |
Y | 103TC0700X | Clinical Psychologist | 5464 | OH |
NPI | 1033129994 |
---|---|
Provider Name | Dr. Josephine Anise Ridley |
First Address | Cleveland Heights, OH 44121-2021 |
Second Address | Cleveland, OH 44106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 05/10/2020 |