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General NPI Number Information
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NPI Number | 1396992509
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Entity Type | Individual
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Provider Name | DAVID EARL RIDLEY SC.D., LMHC
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Gender | Male
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 52 WAIANUENUE AVE ROOM 202
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City | HILO
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State | HI
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Zip | 96720
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Country | US
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Telephone | 808-935-4412
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Fax | 808-969-9447
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Provider Business Mailing Address
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Address Line | 1787 HALEOKEA ST
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City | HILO
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State | HI
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Zip | 96720-5946
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Country | US
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Telephone | 808-959-5911
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMH 100
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License Number State | HI
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