Individual
DR. CHARLES ROBERT RIDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3201 UNIVERSITY DR E, SUITE 200, BRYAN, TX 77802-3475
(812) 340-1714
Mailing address
3201 UNIVERSITY DR E, SUITE 200, BRYAN, TX 77802-3475
(812) 340-1714
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20041066A
IN
103T00000X
Psychologist
Primary
37060
TX
103T00000X
Psychologist
PSY9586
CA
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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