Provider Demographics
NPI:1467122861
Name:RICKS-AYER, JEAN C (CIT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:C
Last Name:RICKS-AYER
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 SHEPARD RD
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63038-1420
Mailing Address - Country:US
Mailing Address - Phone:253-341-8793
Mailing Address - Fax:
Practice Address - Street 1:9666 OLIVE BLVD STE 330
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3035
Practice Address - Country:US
Practice Address - Phone:314-594-7298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional