Individual
GLENN BERNARD RICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISAC
Contact information
Practice address
4909 E MCDOWELL RD, PHOENIX, AZ 85008-7735
(602) 685-6000
(602) 275-1355
Mailing address
3003 N CENTRAL AVE STE 200, PHOENIX, AZ 85012-2914
(602) 685-6000
(602) 265-6973
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-1539
AZ
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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