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Individual

KRISTI ICKES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
8155 W THUNDERBIRD RD, PEORIA, AZ 85381-4159
(623) 336-0164
Mailing address
PO BOX 3066, PEORIA, AZ 85380-3066
(623) 336-0164

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12185
AZ

Other

Enumeration date
07/09/2010
Last updated
07/09/2010
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