Doctor Name: | DEBRA RIDGEWAY |
NPI Number: | 1356715551 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CADC #01895-I |
License Number: | CADC #01895-I |
Business Practice Address: | 415 Us Highway 95a S Suite 501 Fernley, NV - 894089261 |
Business Phone Number: | 7754636597 |
Business Fax Number: | 7754636598 |
Mailing Address: | 720 S Main St, Suite C YERINGTON |
State: | NV |
Postal Code: | 894474217 |
Phone Number: | 7754636597 |
Fax Number: | 7754636598 |
NPI Enumeration Date: | 11/25/2015 |
NPI Last Update Date: | 11/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CADC #01895-I |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |