Organization
BUCKTOWN THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN RIDDER PHD (CLINICAL PSYCHOLOGIST)
(920) 418-1165
Entity
Organization
Contact information
Practice address
1820 W WEBSTER AVE STE 200, CHICAGO, IL 60614-2934
(630) 733-8595
Mailing address
3125 W FULLERTON AVE APT 212, CHICAGO, IL 60647-6959
(920) 418-1165
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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