Individual
MARCELLER RAINA RIDDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
402 HARRIS AVE, RAEFORD, NC 28376-3112
(910) 875-5590
Mailing address
7000 WOODMARK DR, FAYETTEVILLE, NC 28314-8422
(252) 339-6834
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-28013
NC
Other
Enumeration date
06/03/2022
Last updated
06/14/2022
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