Doctor Name: | AMY RICCIARDI |
NPI Number: | 1043631724 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 38820 Hidden Canyon Dr Grafton, OH - 440449222 |
Business Phone Number: | 4402253635 |
Business Fax Number: | |
Mailing Address: | 38820 Hidden Canyon Dr, GRAFTON |
State: | OH |
Postal Code: | 440449222 |
Phone Number: | 4402253635 |
Fax Number: | |
NPI Enumeration Date: | 12/23/2013 |
NPI Last Update Date: | 12/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |