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General NPI Number Information
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NPI Number | 1174621395
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Entity Type | Individual
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Provider Name | GLORIA ANN STICKLER MSW
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1020 IOWA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92507-2105
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Country | US
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Telephone | 951-955-3301
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Fax | 951-955-3889
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Provider Business Mailing Address
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Address Line | 1498 BROOKSIDE AVE APARTMENT 181
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City | REDLANDS
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State | CA
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Zip | 92373-4454
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Country | US
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Telephone | 909-798-9868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW13689
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License Number State | CA
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