Provider Demographics
NPI:1538737002
Name:RICCI, LAUREN ANN (MS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANN
Last Name:RICCI
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 1:1 KITTREDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONT VERNON
Mailing Address - State:NH
Mailing Address - Zip Code:03057
Mailing Address - Country:US
Mailing Address - Phone:603-673-5141
Mailing Address - Fax:
Practice Address - Street 1:1 KITTREDGE RD
Practice Address - Street 2:
Practice Address - City:MONT VERNON
Practice Address - State:NH
Practice Address - Zip Code:03057
Practice Address - Country:US
Practice Address - Phone:603-673-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH90374103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool