Provider Demographics
NPI:1568011203
Name:STICKLER, VALERIA V (VSTCLP)
Entity Type:Individual
Prefix:MRS
First Name:VALERIA
Middle Name:V
Last Name:STICKLER
Suffix:
Gender:F
Credentials:VSTCLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:CLARINDA
Mailing Address - State:IA
Mailing Address - Zip Code:51632-1530
Mailing Address - Country:US
Mailing Address - Phone:712-438-0533
Mailing Address - Fax:
Practice Address - Street 1:125 E WASHINGTON STREET
Practice Address - Street 2:SUITE B
Practice Address - City:CLARINDA
Practice Address - State:IA
Practice Address - Zip Code:51632
Practice Address - Country:US
Practice Address - Phone:712-438-0533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist