Provider Demographics
NPI:1801189980
Name:RICHARDS, JODI-ANN NATALIE
Entity Type:Individual
Prefix:
First Name:JODI-ANN
Middle Name:NATALIE
Last Name:RICHARDS
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 1:2708 NE 14TH STREET, SUITE 5
Mailing Address - Street 2:
Mailing Address - City:POMPANO
Mailing Address - State:FL
Mailing Address - Zip Code:33062
Mailing Address - Country:US
Mailing Address - Phone:786-554-2628
Mailing Address - Fax:
Practice Address - Street 1:2708 NE 14TH STREET, SUITE 5
Practice Address - Street 2:
Practice Address - City:POMPANO
Practice Address - State:FL
Practice Address - Zip Code:33062
Practice Address - Country:US
Practice Address - Phone:954-603-7885
Practice Address - Fax:954-342-0273
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist