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Contact Information

BRENDA K STICKLEY
610 E CHESTNUT ST
WAUSEON, OH43567-1463
 Phone: 419-357-9292
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for BRENDA K STICKLEY · (Female)

NPI Number 1114520046
Status Active
Credentials
Entity Individual
Enumeration date 11/22/2020
Last updated 11/22/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 2695463
  • OH Medicaid 0180383
  • OH Medicaid 2695463
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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