Individual
KODY RICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
152 E MAIN ST STE 110, RIGBY, ID 83442-5268
(208) 745-7101
(208) 745-0068
Mailing address
152 E MAIN ST STE 110, RIGBY, ID 83442-5268
(208) 745-7101
(208) 745-0068
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-1902
ID
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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