Provider Demographics
NPI:1659547073
Name:RITTER, CHERYL PATRICIA (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:PATRICIA
Last Name:RITTER
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:PATRICIA
Other - Last Name:RITTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OCCUPATIONAL THERAPI
Mailing Address - Street 1:640 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-1537
Mailing Address - Country:US
Mailing Address - Phone:715-425-5353
Mailing Address - Fax:
Practice Address - Street 1:640 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-1537
Practice Address - Country:US
Practice Address - Phone:715-425-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4414-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41031800Medicaid