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NPI Code Detail

MEDICARE: NANCY L. RICKS ED.D.

MEDICARE: NANCY L. RICKS ED.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist1859MA
2103TC0700XClinical Psychologist1859MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588625008
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY L. RICKS ED.D.
Provider Business Mailing Address
First Line : 18 CLYFTON ST
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-3904
Country : US
Telephone Number : 508-747-6907
Fax Number : 508-746-8456
Provider Business Practice Location Address
First Line : 16 ALDRIN RD
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-4804
Country : US
Telephone Number : 508-747-6907
Fax Number : 508-746-8456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2006
Last Update Date : 09/20/2010

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Directions to “ NANCY L. RICKS ED.D.” Practice Location

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