Individual
BRANDY T HICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, PSYCHOLOGIST
Contact information
Practice address
17 S CENTRAL AVE, IDABEL, OK 74745-4625
(580) 286-5184
(580) 286-5185
Mailing address
RR 3 BOX 474, BROKEN BOW, OK 74728-9584
(580) 212-2726
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
OK
103TS0200X
School Psychologist
—
OK
Other
Enumeration date
03/05/2007
Last updated
02/12/2008
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