Most Relevant Information
Provider Data
| NPI Number: | 1003499559 |
| Provider Name: | SHANTEL RIDDICK |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/03/2021 |
| Last Updated: | 05/03/2021 |
Provider Practice Location
1001 W 9TH AVE STE C
KING OF PRUSSIA
PA
194061209
Practice Location Phone/Fax
| Phone: | 6108311865 |
| Fax: | 6158151946 |
Provider Mailing Location
1321 MURFREESBORO PIKE STE 702
NASHVILLE
TN
372172679
Provider Mailing Phone/Fax
| Phone: | 6153614000 |
| Fax: | 6158151946 |