Doctor Name: | JESSICA MARIE RYDE |
NPI Number: | 1336534684 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CTRS |
License Number: | 64366 |
Business Practice Address: | 800 Saint Charles Pl Wixom, MI - 483931852 |
Business Phone Number: | 3136552246 |
Business Fax Number: | |
Mailing Address: | 800 Saint Charles Pl, WIXOM |
State: | MI |
Postal Code: | 483931852 |
Phone Number: | 3136552246 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2015 |
NPI Last Update Date: | 04/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225800000X |
License Number: | 64366 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Recreation Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |