MEDICARE: BREANNA FICKLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	7196G	AL

General Provider Information

NPI Number	:	1477402139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREANNA FICKLE

Provider Business Mailing Address
First Line	:	2032 VALLEYDALE RD STE D
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-2095
Country	:	US
Telephone Number	:	205-621-8677
Fax Number	:

Provider Business Practice Location Address
First Line	:	2032 VALLEYDALE RD STE D
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-2095
Country	:	US
Telephone Number	:	205-621-8677
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “ BREANNA FICKLE ” Practice Location

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