Individual
MS. BRENDA CANTER RICKETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED PROFESSIONA
Contact information
Practice address
725 PROVIDENCE RD., SUITE 302, CHARLOTTE, NC 28207
(704) 608-9891
Mailing address
P.O. BOX 4261, DAVIDSON, NC 28036
(704) 608-9891
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2830
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11023
BLUE CROSS BLUE SHIELD
NC
Enumeration date
03/09/2007
Last updated
09/02/2009
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