Provider Demographics
NPI:1366120297
Name:RICKERT, ANNE (OTD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:RICKERT
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4309 S DAKOTA PL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6800
Mailing Address - Country:US
Mailing Address - Phone:605-759-5208
Mailing Address - Fax:
Practice Address - Street 1:4700 W 69TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8757
Practice Address - Country:US
Practice Address - Phone:605-305-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist