Individual
LATISHA RIDDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2814 S US HIGHWAY 1 STE D4, FORT PIERCE, FL 34982-8110
(321) 289-1411
Mailing address
2814 S US HIGHWAY 1 STE D4, FORT PIERCE, FL 34982-8110
(321) 289-1411
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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