| Doctor Name: | JESSICA RIDDLE |
| NPI Number: | 1205146974 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCC |
| License Number: | 1547 |
| Business Practice Address: | 321 E Main St Morehead, KY - 403511671 |
| Business Phone Number: | 6067844161 |
| Business Fax Number: | 6067839952 |
| Mailing Address: | P.o. Box 790, ASHLAND |
| State: | KY |
| Postal Code: | 411050790 |
| Phone Number: | 6063298588 |
| Fax Number: | 6063298195 |
| NPI Enumeration Date: | 10/15/2010 |
| NPI Last Update Date: | 04/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1547 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |