Individual
MIA TICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4342 15TH AVE S STE 105, FARGO, ND 58103-1125
(701) 936-9495
Mailing address
1919 UNIVERSITY DR N APT 314, FARGO, ND 58102-1844
(701) 429-4315
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/15/2025
Last updated
12/15/2025
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