Provider Demographics
NPI:1699942334
Name:RICKLI, JUNE M (MS)
Entity type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:M
Last Name:RICKLI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4323 LOVELAND DR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-6878
Mailing Address - Country:US
Mailing Address - Phone:315-622-4287
Mailing Address - Fax:
Practice Address - Street 1:5 W CAYUGA ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2031
Practice Address - Country:US
Practice Address - Phone:315-342-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health