Individual
MS. ELLEN STICKNEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1835 MIRACLE MILE, SPRINGFIELD, OH 45503-2807
(937) 390-7960
(937) 390-7971
Mailing address
1835 MIRACLE MILE, SPRINGFIELD, OH 45503-2807
(937) 390-7960
(937) 390-7971
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0001049
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000004558
ANTHEM
OH
01
—
0004519076
AETNA
OH
Enumeration date
10/31/2005
Last updated
07/08/2007
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