Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | I7465 | OH |
NPI | 1013008507 |
---|---|
Provider Name | Linda Riddle |
First Address | Apo, AE 09094-3215 |
Second Address | Apo, AE 09094-3215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 02/11/2016 |