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General NPI Number Information
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NPI Number | 1639249360
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Entity Type | Individual
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Provider Name | LISA RICKARD MA, CCC-A
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 358 N PLEASANT ST
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City | AMHERST
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State | MA
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Zip | 01002-1746
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Country | US
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Telephone | 413-545-3669
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Fax | 413-545-0803
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Provider Business Mailing Address
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Address Line | 399 HENRY ST
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City | AMHERST
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State | MA
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Zip | 01002-1255
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Country | US
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Telephone | 413-545-3669
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Fax | 413-545-0803
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 847
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License Number State | MA
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