Individual
TARA J HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NMD
Contact information
Practice address
3538 N HIGHWAY 112, FAYETTEVILLE, AR 72704-5485
(479) 445-2220
Mailing address
977 E OAKS MANOR DR, FAYETTEVILLE, AR 72703-3519
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
09-1163
AZ
Other
Enumeration date
05/01/2010
Last updated
05/01/2010
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