Individual
CYNTHIA Y RIDGWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. LPC
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00553
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00553
LPC
MS
Enumeration date
09/26/2008
Last updated
09/26/2008
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