Individual
GARY A HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 MAHALANI ST, WAILUKU, HI 96793-2528
(808) 984-2150
Mailing address
121 MAHALANI ST, WAILUKU, HI 96793-2528
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41161500
—
WI
Enumeration date
02/02/2010
Last updated
02/02/2010
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