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General NPI Number Information
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NPI Number | 1154766608
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Entity Type | Individual
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Provider Name | TERI MAE RICKABY LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/09/2013
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 566 N CEDAR ST
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City | MASON
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State | MI
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Zip | 48854-1033
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Country | US
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Telephone | 517-676-2461
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Fax | 517-676-3265
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Provider Business Mailing Address
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Address Line | 812 E JOLLY RD STE 311
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City | LANSING
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State | MI
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Zip | 48910-6825
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Country | US
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Telephone | 517-346-8200
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Fax | 517-346-8291
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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