Provider Demographics
NPI:1609525484
Name:STICKLE, JENNY CRISTINA
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:CRISTINA
Last Name:STICKLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 COPLEY RD APT B30
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1585
Mailing Address - Country:US
Mailing Address - Phone:330-810-1010
Mailing Address - Fax:
Practice Address - Street 1:2131 COPLEY RD APT B30
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1585
Practice Address - Country:US
Practice Address - Phone:330-810-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical