Individual
DR. BETHANY CLARKE RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
100 NICHOLLS RD., STONY BROOK, NY 11790-3100
(631) 632-6720
Mailing address
1099 N COUNTRY RD, RT 25 A, STONY BROOK, NY 11790-1924
(631) 655-2714
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017314
NY
Other
Enumeration date
09/09/2007
Last updated
09/29/2011
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