Individual
MRS. SHALONDA RIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 N JACKSON ST, AMERICUS, GA 31709-3015
(229) 406-5296
Mailing address
465 DUNCAN AVE, UNADILLA, GA 31091-3556
(229) 406-5296
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1041S0200X
GA
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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