Individual
MRS. OLIVIA RIDENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
800 BROAD ST, SUMMERSVILLE, WV 26651-1707
(304) 872-7380
(304) 872-7384
Mailing address
800 BROAD ST, SUMMERSVILLE, WV 26651-1707
(304) 872-7380
(304) 872-7384
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C2401
WV
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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