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Individual

JAMIE RICKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
134 STATE ST, MERIDEN, CT 06450-3293
(203) 237-2229
(203) 686-1677
Mailing address
575 MAIN ST FL 2, ATTN: CREDENTIALING DEPT, MIDDLETOWN, CT 06457-2845
(860) 347-6971

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
008114
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004236338
CT
Enumeration date
11/28/2012
Last updated
11/28/2012
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