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General NPI Number Information
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NPI Number | 1720699457
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Entity Type | Individual
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Provider Name | REBECCA LEE RIDDLE-WHITLOW LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | 13623 JAMES MADISON HWY
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City | PALMYRA
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State | VA
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Zip | 22963-4300
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Country | US
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Telephone | 434-589-8276
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Fax |
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Provider Business Mailing Address
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Address Line | 615 BRIGHTON DR
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City | EARLYSVILLE
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State | VA
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Zip | 22936-9654
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Country | US
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Telephone | 434-738-8572
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | VA
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