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Individual

STACY-ANN RICKETTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3901 W STATE ROAD 84 UNIT 308, DAVIE, FL 33312-8865
(407) 580-3906
Mailing address
3901 W STATE ROAD 84 UNIT 308, DAVIE, FL 33312-8865
(407) 580-3906

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10920
FL

Other

Enumeration date
11/01/2023
Last updated
11/01/2023
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