| NPI | 1215684485 |
|---|---|
| Former Name | CRYSTAL M RIDDLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 104100000X Social Worker | |
| 175T00000X Peer Specialist | |
| 225200000X Physical Therapy Assistant | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2022-03-07 |