| NPI | 1316588122 |
|---|---|
| Former Name | LEILA RENEE RIDDICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 106545-1) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 106545-1) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2019-10-02 |