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Individual

MICHELLE HICKOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MASTERS LADC

Contact information

Practice address
1549 NW 37TH ST, OKLAHOMA CITY, OK 73118-2804
(405) 525-9508
Mailing address
1549 NW 37TH ST, OKLAHOMA CITY, OK 73118-2804
(405) 525-9508

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
106H00000X
Marriage & Family Therapist
879
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200079250 A
OK
05
200390770 A
OK
Enumeration date
04/18/2007
Last updated
02/26/2016
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