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Individual
JACOB PAUL RICCARDI
Active
Individual
JACOB PAUL RICCARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTRL
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11218
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11218
NBCOT LICENSURE NUMBER
MA
Enumeration date
10/23/2014
Last updated
10/23/2014
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