Individual
MRS. JESSICA LYNN RICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1740 E 17TH ST STE C, IDAHO FALLS, ID 83404-6375
(208) 524-1278
(208) 529-3184
Mailing address
872 CAPITAL AVE, REXBURG, ID 83440-5312
(208) 441-8284
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW-28696
ID
Other
Enumeration date
01/04/2010
Last updated
01/04/2010
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