Individual
RENAE N RICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1109 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6105
(715) 717-4338
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6519-26
WI
Other
Enumeration date
05/17/2019
Last updated
12/08/2020
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