Provider Demographics
NPI:1114683893
Name:BLUE, RIKKI (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:RIKKI
Middle Name:
Last Name:BLUE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 KUYKENDALL
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-8182
Mailing Address - Country:US
Mailing Address - Phone:512-818-6770
Mailing Address - Fax:
Practice Address - Street 1:801 BARTON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-1146
Practice Address - Country:US
Practice Address - Phone:512-818-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist