Individual
CRYSTAL BESSIE TICKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 BACK STREET, SHUNGNAK, AK 99778
(907) 437-2138
(907) 437-2139
Mailing address
PO BOX 256, KOTZEBUE, AK 99752-0256
(907) 442-7612
(907) 437-2139
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/07/2020
Last updated
06/23/2020
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