Individual
DR. JILL L RICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1535 KILLEARN CENTER BLVD, SUITE D-1, TALLAHASSEE, FL 32309-3467
(850) 877-6011
(850) 893-6013
Mailing address
PO BOX 15755, TALLAHASSEE, FL 32317-5755
(850) 877-6011
(850) 893-6013
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY0004423
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73698
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/16/2007
Last updated
07/08/2007
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