Individual
THOMAS P RIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
50 MOODY ST, SACO, ME 04072-1536
(800) 434-3000
Mailing address
50 MOODY ST, SACO, ME 04072-1536
(800) 434-3000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC1974
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265200099
—
ME
Enumeration date
08/26/2010
Last updated
08/26/2010
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