Individual
JENNIFER RICCOBONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
55951 GRATIOT AVE, CHESTERFIELD, MI 48051-1221
(586) 438-0069
Mailing address
50598 HELMANDALE ST, CHESTERFIELD, MI 48047-3636
(586) 438-0069
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361008210
MI
103TC0700X
Clinical Psychologist
Primary
6362009367
MI
Other
Enumeration date
02/06/2018
Last updated
05/18/2026
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