Individual
STEPHANIE ANN JICKESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 791-3800
Mailing address
500 E REGENCY CIR, CANFIELD, OH 44406-9643
(330) 502-0000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT010713
OH
Other
Enumeration date
07/23/2019
Last updated
12/16/2019
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