| Doctor Name: | JESSICA S. RIDGILL |
| NPI Number: | 1003926361 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 101 Commercial Dr Abbeville, SC - 296205593 |
| Business Phone Number: | 2644599671 |
| Business Fax Number: | 8644592487 |
| Mailing Address: | 1547 Parkway, Suite 100 GREENWOOD |
| State: | SC |
| Postal Code: | 296464081 |
| Phone Number: | 8642297120 |
| Fax Number: | 8642295526 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |