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Individual

TAYLOR JEAN RICKERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.S, LADC

Contact information

Practice address
116 3RD ST NW, BEMIDJI, MN 56601-3102
(218) 556-8753
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
305795
MN

Other

Enumeration date
09/22/2020
Last updated
04/14/2022
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