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General NPI Number Information
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NPI Number | 1255640967
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Entity Type | Individual
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Provider Name | MRS. ELIZABETH RICCA
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Gender | Female
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 2111 COWLES ST
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City | FAIRBANKS
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State | AK
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Zip | 99701-5918
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Country | US
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Telephone | 907-458-2644
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Fax | 907-459-3521
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Provider Business Mailing Address
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Address Line | PO BOX 73720
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City | FAIRBANKS
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State | AK
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Zip | 99707-3720
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Country | US
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Telephone | 347-733-2003
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 073654
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 165188
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License Number State | AK
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