Individual
MRS. HEIDI TANYA RICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A./L
Contact information
Practice address
6636 CEDAR AVE S, MINNEAPOLIS, MN 55423-2705
(612) 467-4610
Mailing address
2800 43RD AVE S, MINNEAPOLIS, MN 55406-1821
(612) 590-1537
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
201701
MN
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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