Individual
AGNES RIDGELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21585 PEABODY ST, LEONARDTOWN, MD 20650-2955
(301) 475-8000
Mailing address
39608 LADY BALTIMORE AVE, LEONARDTOWN, MD 20650-2534
(301) 672-2579
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3417034
—
MD
Enumeration date
10/04/2018
Last updated
10/04/2018
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