Individual
AMY JEFFRIES RIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
213 W MASON ST STE B, ODESSA, MO 64076-1262
(653) 229-7816
Mailing address
213 W MASON ST STE B, ODESSA, MO 64076-1262
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2018040821
MO
Other
Enumeration date
11/13/2018
Last updated
11/13/2018
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