Individual
COLLEEN ELIZABETH HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LMCH
Contact information
Practice address
3525 ENSIGN RD NE, MEDICAL RESOURCE CENTER SUITE G, OLYMPIA, WA 98506
(360) 438-7188
Mailing address
PO BOX 1172, TENINO, WA 98589
(360) 438-7188
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH00007231
WA
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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