Individual
DIA DANAE HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC CADC
Contact information
Practice address
9378 OLIVE BLVD, SUITE 202, OLIVETTE, MO 63132-3223
(314) 730-0083
(612) 241-2552
Mailing address
9378 OLIVE BLVD, SUITE 202, OLIVETTE, MO 63132-3223
(314) 730-0083
(612) 241-2552
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6614
MO
101YM0800X
Mental Health Counselor
Primary
2014008242
MO
Other
Enumeration date
10/19/2015
Last updated
03/03/2021
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