Provider Demographics
NPI:1164960936
Name:ANDERSSON-RIGGS, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ANDERSSON-RIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1417
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:CO
Mailing Address - Zip Code:80446-1417
Mailing Address - Country:US
Mailing Address - Phone:303-330-4667
Mailing Address - Fax:
Practice Address - Street 1:171 CHIPMUNK DR/171 GCOUNTY RD #8980
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CO
Practice Address - Zip Code:80446-8044
Practice Address - Country:US
Practice Address - Phone:303-330-4667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT 0001532225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COOT 0001532OtherOT LISCENSE