Individual
MR. BOBBY RAY RIDDICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5816 ASHLEYANNE CIR STE 400, WICHITA FALLS, TX 76310-1613
(940) 757-0660
(940) 757-0663
Mailing address
207 THOR ST APT A, SHEPPARD AFB, TX 76311-4417
(804) 939-0653
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-281923
TX
Other
Enumeration date
06/29/2023
Last updated
06/29/2023
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