Provider Demographics
NPI:1811758964
Name:RICKER, ANGELA (HIS)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:RICKER
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 HARDY CASH DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2420
Mailing Address - Country:US
Mailing Address - Phone:757-827-7694
Mailing Address - Fax:757-299-8435
Practice Address - Street 1:1507 HARDY CASH DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2420
Practice Address - Country:US
Practice Address - Phone:757-827-7694
Practice Address - Fax:757-299-8435
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101002707237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist