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Individual

DR. PAUL T HICKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD, LPC

Contact information

Practice address
106 E MAIN, RUSSELLVILLE, AR 72801-5128
(479) 692-1208
(866) 538-2772
Mailing address
PO BOX 1251, FARMINGTON, AR 72730-9998
(479) 692-1208
(866) 538-2772

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P1408057
AR

Other

Enumeration date
05/10/2011
Last updated
11/15/2023
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