Individual
DONNA WONG RICKARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,OTR/L
Contact information
Practice address
12145 BRIDGETON SQ, BRIDGETON, MO 63044-2616
(207) 650-4340
Mailing address
12145 BRIDGETON SQ, BRIDGETON, MO 63044-2616
(207) 650-4340
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
9479
MA
225X00000X
Occupational Therapist
OT01087
RI
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
2009012932
MO
Other
Enumeration date
10/17/2007
Last updated
04/06/2012
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