Rickie C Cannon Jr., COTA/L
Occupational Therapy Assistant in Little River, SC. Individual provider (NPI-1).
NPI number1104768902
StatusActive
Last updated in NPPESApr 8, 2026
Details
- NPI
- 1104768902
- Entity type
- Individual (NPI-1)
- Name
- Rickie C Cannon Jr.
- Credential
- COTA/L
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 8, 2026
- Certification date
- Apr 8, 2026
- Last updated
- Apr 8, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 5165 | SC | Yes |
Practice location
4455 Barcelona LnLittle River, SC 29566-8264
Phone 828-729-2085
Mailing address
4455 Barcelona LnLittle River, SC 29566-8264
Phone 828-729-2085
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