Ricketts, Percival George

Ricketts, Percival George is an individual health care provider with primary practice located at 10031 Pines Blvd #242, Pembroke Pines FL 33024-6179. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Ricketts, Percival George can be contacted via phone (954) 438-5661.

Contact Information

Primary practice address
10031 Pines Blvd #242 Pembroke Pines FL 33024-6179
Phone: (954) 438-5661
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH6153 Florida

Profile Details

NPI number 1053397471
LBN Legal business name Ricketts, Percival George
Credentials ED.D, LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 17th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053397471 NPPES
Florida Other MH6153 STATE LICENCE NUMBER

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