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Individual

AUTUMN CAMPBELL RICKER GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
200 SPRINGS RD # 122, BEDFORD, MA 01730-1114
(781) 687-2000
Mailing address
200 SPRINGS RD # 122, BEDFORD, MA 01730-1114
(781) 687-2000

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
116382
MA
1041C0700X
Clinical Social Worker
Primary
116382
MA
1041C0700X
Clinical Social Worker

Other

Enumeration date
11/30/2012
Last updated
10/24/2024
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