Individual
ANSLEY RIDGEWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 W 5TH ST, GRIDLEY, IL 61744-9793
(309) 532-3802
Mailing address
310 W 5TH ST, GRIDLEY, IL 61744-9793
(309) 532-3802
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-60867
IL
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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