Individual
JASMINE RIDDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
780 LYNNHAVEN PKWY STE 400, VIRGINIA BEACH, VA 23452-7332
(954) 947-3192
Mailing address
1317 W TANNERS CREEK DR, NORFOLK, VA 23513-1320
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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