Doctor Name: | ELLEN R FICKS |
NPI Number: | 1316116668 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 135 Marion Road Wareham, MA - 02571 |
Business Phone Number: | 5083424701 |
Business Fax Number: | |
Mailing Address: | 135 Marion Rd, WAREHAM |
State: | MA |
Postal Code: | 025711423 |
Phone Number: | 5083424701 |
Fax Number: | |
NPI Enumeration Date: | 02/20/2008 |
NPI Last Update Date: | 09/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |