Individual
MARCELLA RIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4515 SPRUILL AVE, NORTH CHARLESTON, SC 29405-4764
(843) 352-7049
(615) 815-1946
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-71216
SC
106E00000X
Assistant Behavior Analyst
0-23-14490
SC
106S00000X
Behavior Technician
RBT-21-172389
SC
Other
Enumeration date
06/08/2021
Last updated
04/24/2024
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