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General NPI Number Information
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NPI Number | 1356998819
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Entity Type | Individual
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Provider Name | DARIAN PAIGE RIDDICK MS, CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 5245 N SOCRUM LOOP RD
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City | LAKELAND
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State | FL
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Zip | 33809-4253
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Country | US
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Telephone | 863-859-1446
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Fax |
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Provider Business Mailing Address
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Address Line | 18002 RICHMOND PLACE DR APT 515
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City | TAMPA
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State | FL
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Zip | 33647-1726
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Country | US
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Telephone | 304-561-8645
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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