Healthcare Provider Details

I. General information

NPI: 1134508963
Provider Name (Legal Business Name): BRITTNEY RIDDICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 ELLICOTT CENTER DR # 749
ELLICOTT CITY MD
21043-4100
US

IV. Provider business mailing address

3375 ELLICOTT CENTER DR # 749
ELLICOTT CITY MD
21043-4100
US

V. Phone/Fax

Practice location:
  • Phone: 443-650-8516
  • Fax:
Mailing address:
  • Phone: 443-650-8516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberM07146
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: