Doctor Name: | MRS. TAMMY JEAN RICKETTS |
NPI Number: | 1437248556 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 0890000987 |
Business Practice Address: | 12647 Olive Blvd Saint Louis, MO - 631416345 |
Business Phone Number: | 3147444223 |
Business Fax Number: | |
Mailing Address: | 11947 Mckibben Ct, EL PASO |
State: | TX |
Postal Code: | 79908 |
Phone Number: | 9153074577 |
Fax Number: | |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 09/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 0890000987 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |