Individual
DANIEL KICKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
625 MERAMEC STATION RD, MANCHESTER, MO 63021-5550
(314) 266-6159
Mailing address
914 KENT CT, BALLWIN, MO 63011-3013
(417) 848-0410
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2025009355
MO
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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