Individual
MS. AMY RICEDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCC
Contact information
Practice address
4507 U S HIGHWAY 49, HATTIESBURG, MS 39401-9012
(601) 545-2925
(601) 545-2926
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
(601) 705-1952
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
255326
MS
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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