Individual
LISA RICKETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3607 MANCHACA RD, AUSTIN, TX 78704-5947
(512) 444-7215
(512) 444-6005
Mailing address
3607 MANCHACA RD, AUSTIN, TX 78704-5947
(512) 444-7215
(512) 444-6005
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
105992
TX
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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