Provider Demographics
NPI:1558730663
Name:STICKLER, AMANDA JEAN (ASSOCIATE SOCIAL WOR)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JEAN
Last Name:STICKLER
Suffix:
Gender:F
Credentials:ASSOCIATE SOCIAL WOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 US-98
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32512-0001
Mailing Address - Country:US
Mailing Address - Phone:360-204-4884
Mailing Address - Fax:
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1208
Practice Address - Country:US
Practice Address - Phone:619-532-7150
Practice Address - Fax:619-532-9501
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW196111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical