ETHAN RIDENOUR, COTA/L

Occupational Therapy Assistant

Active Individual
NPI: 1912319039

Practice Address

320 4TH STREET
Carrollton, IL 62016

Phone: (314) 328-9362

Specialties

Specialty Code Primary License
Occupational Therapy Assistant 224Z00000X Yes 057004022 (IL)
Occupational Therapist 225X00000X No 056004047 (IL)
Speech-Language Pathologist 235Z00000X No 146010465 (IL)

Frequently Asked Questions

NPI 1912319039 is the National Provider Identifier for ETHAN RIDENOUR, COTA/L, a Occupational Therapy Assistant provider located in Carrollton, IL. This NPI was enumerated on May 22, 2014.
ETHAN RIDENOUR, COTA/L practices at 320 4TH STREET, Carrollton, IL 62016.

Quick Facts

NPI
1912319039
Type
Individual
Enumerated
May 22, 2014
Last Updated
Oct 15, 2018

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