Healthcare Provider Details

I. General information

NPI: 1235397837
Provider Name (Legal Business Name): NORMANIE MCKENZIE RICKS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NORMANIE MCKENZIE GARRETT OTR

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16320 ROSCOE BLVD
VAN NUYS CA
91406-1250
US

IV. Provider business mailing address

2265 ROSWELL RD STE 100
MARIETTA GA
30062-2980
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-2273
  • Fax: 818-357-2505
Mailing address:
  • Phone: 770-509-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT004714
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: