Provider Demographics
NPI:1861208852
Name:RIDGEWAY, JAYCEE R
Entity type:Individual
Prefix:
First Name:JAYCEE
Middle Name:R
Last Name:RIDGEWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68150 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8547
Mailing Address - Country:US
Mailing Address - Phone:330-842-1282
Mailing Address - Fax:
Practice Address - Street 1:68150 BAYBERRY DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8547
Practice Address - Country:US
Practice Address - Phone:330-842-1282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator