Provider Demographics
NPI:1891432811
Name:STEGALL, ARICKA J
Entity Type:Individual
Prefix:
First Name:ARICKA
Middle Name:J
Last Name:STEGALL
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 1:7413 EASTERN DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-2443
Mailing Address - Country:US
Mailing Address - Phone:817-637-9439
Mailing Address - Fax:
Practice Address - Street 1:7413 EASTERN DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-2443
Practice Address - Country:US
Practice Address - Phone:817-637-9439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator