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1487091120
TINA MARIA RICKS
IDAHO FALLS, ID
NPI
1487091120
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID LMSW-32947)
Enumeration Date
2013-06-03
Last Update Date
2019-01-09
Business Address
TINA MARIA RICKS LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402
Phone number: 208-524-7400
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Mailing Address
TINA MARIA RICKS LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-524-7400
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