Individual
SABRINA RENEA FICKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1021 8TH AVE NW, ARDMORE, OK 73401-4015
(580) 220-0857
Mailing address
1021 8TH AVE NW, ARDMORE, OK 73401-4015
(580) 220-0857
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
M080989998
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M080989998
STATE OF OKLAHOMA
OK
Enumeration date
02/06/2020
Last updated
02/06/2020
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