Individual
SUNNY JEANI TICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4550 W. OAKEY BLVD., SUITE # 111-Q, LAS VEGAS, NV 89102
(702) 375-5500
(702) 360-1161
Mailing address
908 DOMNUS LN., #206, LAS VEGAS, NV 89144-0855
(702) 375-5500
(702) 360-1161
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2850-C
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2850-C
NV. ST. LIC SOCIAL WORK
NV
Enumeration date
09/28/2006
Last updated
11/01/2007
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