Individual
KATHERINE LORIE RICKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
6006 W PORT LN APT 102, BOISE, ID 83703-4896
(208) 949-6220
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-37293
ID
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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