Individual
MS. MARY ANN RICCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CARC
Contact information
Practice address
155 WEST MAIN, PORT JERVIS, NY 12771
(845) 699-3713
Mailing address
155 WEST MAIN STREET, PORT JERVIS, NY 12771
(845) 672-3197
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CARC-4460
NY
Other
Enumeration date
05/20/2020
Last updated
05/20/2020
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