Individual
FRED RICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
254 INGLESIDE DR, MADISON, MS 39110-9524
(601) 695-1919
(601) 420-5299
Mailing address
PO BOX 1995, MADISON, MS 39130-1995
(601) 695-1919
(601) 420-5299
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1005
LA
Other
Enumeration date
01/26/2010
Last updated
12/27/2011
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