Provider Demographics
NPI:1417346842
Name:RICKARDS, CINDY (COTA/L, CDP, CEAS)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:RICKARDS
Suffix:
Gender:F
Credentials:COTA/L, CDP, CEAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24358 PETERKINS RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-2725
Mailing Address - Country:US
Mailing Address - Phone:302-249-5223
Mailing Address - Fax:
Practice Address - Street 1:24358 PETERKINS RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-2725
Practice Address - Country:US
Practice Address - Phone:302-249-5223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA0000666224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant