Individual
CEDDETH RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
4134 DUNN AVE, JACKSONVILLE, FL 32218-4410
(904) 766-2297
Mailing address
5506 S MACDILL AVE, TAMPA, FL 33611-4425
(352) 514-4773
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12244
FL
Other
Enumeration date
05/01/2011
Last updated
05/01/2011
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