Healthcare Provider Details

I. General information

NPI: 1528988730
Provider Name (Legal Business Name): AMANDA STICKLES AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TESSITORE CT UNIT B
MONTROSE CO
81401-5689
US

IV. Provider business mailing address

2515 FORESIGHT CIR UNIT 200
GRAND JUNCTION CO
81505-1156
US

V. Phone/Fax

Practice location:
  • Phone: 970-787-4710
  • Fax: 970-615-7007
Mailing address:
  • Phone: 970-245-2400
  • Fax: 970-242-9092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD.0001395
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: