Individual
JESSICA LANE RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 ENERGY PKWY, LAFAYETTE, LA 70508-3818
(337) 504-4244
Mailing address
108 ENERGY PKWY, LAFAYETTE, LA 70508-3818
(337) 504-4244
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200520
LA
Other
Enumeration date
01/27/2012
Last updated
01/27/2012
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