Individual
MS. CAROL ANN RICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
624 MAIN ST, IRWIN, PA 15642
(724) 863-0226
Mailing address
624 MAIN ST, IRWIN, PA 15642-3431
(724) 863-0226
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW017189
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027201200001
—
PA
Enumeration date
01/01/2012
Last updated
06/18/2018
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