Ridley, Robert Myron

Ridley, Robert Myron is an sole proprietor health care provider with primary practice located at 441 E Broad St Suite H, Cookeville TN 38501-3389. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Ridley, Robert Myron can be contacted via phone (931) 544-1096.

Contact Information

Primary practice address
441 E Broad St Suite H Cookeville TN 38501-3389
Phone: (931) 544-1096
Fax: (931) 451-3774
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC0000001599 Tennessee

Profile Details

NPI number 1891777264
LBN Legal business name Ridley, Robert Myron
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 18th, 2005
Last updated Dec 22nd, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891777264 NPPES
Tennessee MEDICAID 5441348

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