Individual
MS. MARY A RICKETSON
Active
Individual
MS. MARY A RICKETSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA ED
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
524
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102373
—
NC
01
—
71661
BCBS
NC
01
—
CO374
MEDCOST
NC
Enumeration date
04/11/2007
Last updated
07/08/2007
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