Individual
CHRISTY JULIE RIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3776 MOCHA LN, SANTA ROSA, CA 95403-1596
(707) 477-4079
Mailing address
3776 MOCHA LN, SANTA ROSA, CA 95403-1596
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12426
CA
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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