Individual
GRACE HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 CHANLON RD, NEW PROVIDENCE, NJ 07974-1543
(973) 299-9954
Mailing address
121 CHANLON RD, NEW PROVIDENCE, NJ 07974-1543
(973) 299-9954
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00633200
NJ
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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