ETHAN RIDENOUR, COTA/L
Occupational Therapy Assistant
Active
Individual
NPI: 1912319039
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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