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Individual
PEARL B RICKLIS
Active
Individual
PEARL B RICKLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC01310300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0021784
—
NJ
01
—
072145
VALUE OPTION ID
NJ
01
—
270260
MHN ID
NJ
01
—
7286582
AETNA
NJ
01
—
7482682
GHI ID
NJ
01
—
P-841937
OXFORD
NJ
Enumeration date
08/12/2006
Last updated
07/09/2007
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