Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 5201000419 | MI |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201000419 | MI |
NPI | 1659801603 |
---|---|
Provider Name | Dr. Anne T Riddering |
First Address | Livonia, MI 48150-2228 |
Second Address | Livonia, MI 48150-2228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2017 |
Last Update Date | 13/06/2017 |