Individual
TYRA RICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 E LOGAN ST STE 201, CALDWELL, ID 83605-4883
(208) 454-1480
Mailing address
211 E LOGAN ST STE 201, CALDWELL, ID 83605-4883
(208) 454-1480
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10588
ID
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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