Provider Demographics
NPI:1942978168
Name:RITCHIE, LIZA MARIE
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:MARIE
Last Name:RITCHIE
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 1:20232 FOXBORO ST
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7916
Mailing Address - Country:US
Mailing Address - Phone:734-479-0911
Mailing Address - Fax:
Practice Address - Street 1:19697 ALLEN RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1119
Practice Address - Country:US
Practice Address - Phone:734-479-0437
Practice Address - Fax:734-479-0495
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation