Individual
OLIVIA S TICKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 S VASSAR CT, WICHITA, KS 67210-1155
(316) 512-1658
Mailing address
PO BOX 21404, WICHITA, KS 67208-7404
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
10/09/2024
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