MEDICARE: KAYLEE SUE RITENOUR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	5682	SC
2	224Z00000X	Occupational Therapy Assistant	219059	TX

General Provider Information

NPI Number	:	1831054667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE SUE RITENOUR

Provider Business Mailing Address
First Line	:	121 PANTHER DR
Second Line	:
City	:	NINETY SIX
State	:	SC
Zip	:	29666-1512
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2335 E SAUNDERS ST
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-5434
Country	:	US
Telephone Number	:	956-791-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2025
Last Update Date	:	03/02/2026

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Directions to “ KAYLEE SUE RITENOUR ” Practice Location

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