Basic Information
| Provider Information | |||||||||
| NPI: | 1588862049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICKEY | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PCC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ARNETT | ||||||||
| OtherFirstName: | BARBARA | ||||||||
| OtherMiddleName: | R | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | PCC | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 601 S. EDWIN C. MOSES BLVD | ||||||||
| Address2: | 1ST FLOOR, NW BUILDING | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454173424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372244646 | ||||||||
| FaxNumber: | 9372241625 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 S. EDWIN C. MOSES BLVD | ||||||||
| Address2: | 1ST FLOOR, NW BUILDING | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454173424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372244646 | ||||||||
| FaxNumber: | 9372241625 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2007 | ||||||||
| LastUpdateDate: | 12/11/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | E0007018 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.