Individual
MRS. TAMMY JEAN RICKETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
12647 OLIVE BLVD, SAINT LOUIS, MO 63141-6345
(314) 744-4223
Mailing address
11947 MCKIBBEN CT, EL PASO, TX 79908
(915) 307-4577
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0890000987
VT
Other
Enumeration date
10/12/2006
Last updated
09/13/2007
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