Provider Demographics
NPI:1033325196
Name:RICKMAN, DONNA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:RICKMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16040 GODDARD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101
Mailing Address - Country:US
Mailing Address - Phone:734-785-7705
Mailing Address - Fax:734-287-8221
Practice Address - Street 1:16040 GODDARD RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-3304
Practice Address - Country:US
Practice Address - Phone:734-785-7705
Practice Address - Fax:734-287-8221
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000508174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist