Provider Demographics
NPI:1689771131
Name:REICHERT, RITA MARIE (COTA)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:MARIE
Last Name:REICHERT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1JEFFERSON BARRACKS DRIVE
Mailing Address - Street 2:117 JB
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125
Mailing Address - Country:US
Mailing Address - Phone:314-652-4100
Mailing Address - Fax:314-894-6629
Practice Address - Street 1:1JEFFERSON BARRACKS DRIVE
Practice Address - Street 2:117 JB
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:314-894-6629
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant