Individual
AUTUMN MARIE RIDOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
590 FISHERS STATION DR STE 130, VICTOR, NY 14564-9744
(585) 924-7207
Mailing address
522 DODGE RD, FREWSBURG, NY 14738-9742
(716) 397-1772
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
010756-01
NY
225X00000X
Occupational Therapist
Primary
029371
NY
Other
Enumeration date
05/26/2021
Last updated
08/13/2025
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