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General NPI Number Information
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NPI Number | 1750433884
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Entity Type | Individual
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Provider Name | SHARON DIANE SICKLES LISW
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6900 UNIVERSITY AVE STE 135
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City | WINDSOR HEIGHTS
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State | IA
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Zip | 50311
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Country | US
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Telephone | 515-243-1020
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Fax | 515-883-1946
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Provider Business Mailing Address
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Address Line | 1017 35TH ST
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City | DES MOINES
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State | IA
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Zip | 50311
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Country | US
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Telephone | 515-971-4446
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 05925
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License Number State | IA
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