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General NPI Number Information
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NPI Number | 1013003953
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Entity Type | Individual
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Provider Name | ROBYN L RICKERT M.S., L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 130 E WALNUT ST SUITE 406
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City | GREEN BAY
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State | WI
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Zip | 54301-4239
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Country | US
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Telephone | 920-884-1187
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Fax | 920-227-4100
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Provider Business Mailing Address
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Address Line | 130 E WALNUT ST STE 406 P.O. BOX 1108
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City | GREEN BAY
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State | WI
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Zip | 54301-4231
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Country | US
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Telephone | 920-884-1187
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Fax | 920-227-4100
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2975125
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License Number State | WI
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