Individual
MRS. TRACI KRISTINE RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4009 EUFAULA AVE, MUSKOGEE, OK 74403-1132
(918) 682-2841
(918) 686-6859
Mailing address
609 CARY PL, MUSKOGEE, OK 74403-8581
(918) 686-7987
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2259
OK
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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