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General NPI Number Information
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NPI Number | 1194878488
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Entity Type | Individual
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Provider Name | MS. LUCY ARIAS-RICKETTS
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 616 W RUSSELL PL
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City | SAN ANTONIO
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State | TX
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Zip | 78212-3658
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Country | US
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Telephone | 800-257-8715
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Fax | 800-819-1655
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Provider Business Mailing Address
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Address Line | 319 BROOKHAVEN DR
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-3587
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Country | US
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Telephone | 214-460-5535
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Fax |
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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 | 12593
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License Number State | TX
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