Individual
ANNA NICOLE HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCA
Contact information
Practice address
4949 S MACADAM AVE FL 2, PORTLAND, OR 97239-3912
(971) 910-3838
Mailing address
4949 S MACADAM AVE FL 2, PORTLAND, OR 97239-3912
(971) 910-3838
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R8237
OR
Other
Enumeration date
06/12/2021
Last updated
05/02/2023
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