NPI | 1891192688 |
---|---|
Other Name | LINDA CLARK RIDENOUR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 76) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: OK OCC-05967) |
Enumeration Date | 2014-11-23 |
Last Update Date | 2015-01-20 |