Most Relevant Information
Provider Data
| NPI Number: | 1003381120 |
| Provider Name: | AGNES RIDGELL |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/04/2018 |
| Last Updated: | 10/04/2018 |
Provider Practice Location
21585 PEABODY ST
LEONARDTOWN
MD
206502955
Practice Location Phone/Fax
| Phone: | 3014758000 |
| Fax: |
Provider Mailing Location
39608 LADY BALTIMORE AVE
LEONARDTOWN
MD
206502534
Provider Mailing Phone/Fax
| Phone: | 3016722579 |
| Fax: |