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NPI Code Detail

MEDICARE: JUDY RICCI PHD

MEDICARE: JUDY RICCI PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist02644MD

General Provider Information

NPI Number : 1265052526
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY RICCI PHD
Provider Business Mailing Address
First Line : 610 PROFESSIONAL DR STE 255
Second Line :
City : GAITHERSBURG
State : MD
Zip : 20879-3463
Country : US
Telephone Number : 240-683-6202
Fax Number :
Provider Business Practice Location Address
First Line : 610 PROFESSIONAL DR STE 255
Second Line :
City : GAITHERSBURG
State : MD
Zip : 20879-3463
Country : US
Telephone Number : 240-683-6202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2020
Last Update Date : 04/16/2020

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Directions to “ JUDY RICCI PHD” Practice Location

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