Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 37PC003350700 | NJ |
NPI | 1003021189 |
---|---|
Provider Name | Erica R Riczu |
First Address | Toms River, NJ 08755-6431 |
Second Address | Toms River, NJ 08755-6431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 09/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20-5693623 | TAX IDENTIFICATION NUMBER (01) |