Provider Demographics
NPI:1356012819
Name:RIDDLE, ZAYLE DAWN (LPC)
Entity Type:Individual
Prefix:
First Name:ZAYLE
Middle Name:DAWN
Last Name:RIDDLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ZAYLE
Other - Middle Name:DAWN
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2101 W PEARL ST
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-1894
Mailing Address - Country:US
Mailing Address - Phone:817-579-4400
Mailing Address - Fax:
Practice Address - Street 1:104 PIRATE DR
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-5682
Practice Address - Country:US
Practice Address - Phone:817-573-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional