Individual
MS. JACQUELYN R RIDDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC.
Contact information
Practice address
394 HASBROUCK AVE., KINGSTON, NY 12401
(845) 750-4896
Mailing address
394 HASBROUCK AVE #2C, KINGSTON, NY 12401
(845) 750-4896
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005208-1
NY
171100000X
Acupuncturist
25 005208
NY
225700000X
Massage Therapist
019298-1
NY
Other
Enumeration date
04/14/2014
Last updated
09/13/2023
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