Individual
DEBBIE FICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO
Contact information
Practice address
1012 S STAPLEY DR BLDG 5, MESA, AZ 85204-4270
(480) 768-6022
Mailing address
1012 S STAPLEY DR BLDG 5, MESA, AZ 85204-4270
(480) 768-6022
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330034005
MEDICAID REHAB
AL
Enumeration date
06/15/2006
Last updated
07/06/2020
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