Individual
MICHELLE L RICKERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY STREET, POTTER BASEMENT, PROVIDENCE, RI 02903-4923
(401) 444-8638
(401) 444-2085
Mailing address
593 EDDY STREET, POTTER 3, PROVIDENCE, RI 02903-4923
(401) 444-4318
(401) 444-6573
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD09800
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MR27488
—
RI
Enumeration date
07/18/2006
Last updated
09/03/2013
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