Provider Demographics
NPI:1326478967
Name:RICCADONNA, JULIANNE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:
Last Name:RICCADONNA
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 1:212 TYLER DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-3218
Mailing Address - Country:US
Mailing Address - Phone:724-774-5422
Mailing Address - Fax:
Practice Address - Street 1:257 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-9740
Practice Address - Country:US
Practice Address - Phone:724-846-8200
Practice Address - Fax:724-847-2998
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001808L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist