Individual
ALEX RIDDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCAS
Contact information
Practice address
877 E GANNON AVE STE 103, ZEBULON, NC 27597-9445
(314) 496-2568
(919) 829-1357
Mailing address
1000 BRIGHTHURST DR UNIT 210, RALEIGH, NC 27605-1282
(252) 862-6050
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P010437
NC
Other
Enumeration date
06/06/2016
Last updated
11/10/2020
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