Provider Demographics
NPI:1841036555
Name:HERRING, RICHARD ANDREW (OTR/L)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ANDREW
Last Name:HERRING
Suffix:
Gender:M
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 1:802 LAKELAND DR APT 104
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4613
Mailing Address - Country:US
Mailing Address - Phone:601-466-0221
Mailing Address - Fax:
Practice Address - Street 1:501 BAPTIST DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-2030
Practice Address - Country:US
Practice Address - Phone:601-898-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT-4154225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand