Individual
KRISTA SICKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1979 MARCUS AVENUE, SUITE 204, LAKE SUCCESS, NY 11042
(310) 721-4871
Mailing address
PO BOX 801, KERHONKSON, NY 12446-0801
(310) 721-4871
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0157571
NY
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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