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General NPI Number Information
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NPI Number | 1205074200
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Entity Type | Organization
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Legal Business Name | JENNIFER R. RICKER LSCSW PA
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 101 E 1ST AVE
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City | HUTCHINSON
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State | KS
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Zip | 67501-7147
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Country | US
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Telephone | 620-662-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 3903 QUIVIRA DR
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City | HUTCHINSON
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State | KS
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Zip | 67502-2235
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Country | US
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Telephone | 620-663-8987
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER R RICKER
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Credential | LSCSW PA
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Telephone | 620-663-8987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LSCSW 3864
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License Number State | KS
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