Individual
JESSICA RIEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
N4470 19TH RD, POUND, WI 54161-9409
(920) 591-0526
Mailing address
N4470 19TH RD, POUND, WI 54161-9409
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372600000X
Adult Companion
—
—
385H00000X
Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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