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1770766933
JUSTIN LEE RICKS
SAN JOSE, CA
NPI
1770766933
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2007-12-11
Last Update Date
2007-12-11
Business Address
Mr. JUSTIN LEE RICKS BA
232 E GISH RD
SAN JOSE, CA 95112-4706
Phone number: 408-876-4217
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Mailing Address
Mr. JUSTIN LEE RICKS BA
520 RAILWAY AVE APT 287
CAMPBELL, CA 95008-3036
Phone number: 408-876-4217
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