Provider Demographics
NPI:1124652003
Name:RIDDICK, ANNE SYDNEY (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:SYDNEY
Last Name:RIDDICK
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 JOELENE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-1533
Mailing Address - Country:US
Mailing Address - Phone:252-883-7968
Mailing Address - Fax:888-393-2093
Practice Address - Street 1:2024 JOELENE DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-1533
Practice Address - Country:US
Practice Address - Phone:252-883-7968
Practice Address - Fax:888-393-2093
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13545235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist