Individual
KELLIE HICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
78 CENTENNIAL LOOP STE A, EUGENE, OR 97401-7900
(541) 393-0777
(541) 687-9279
Mailing address
78 CENTENNIAL LOOP STE A, EUGENE, OR 97401-7900
(541) 393-0777
(541) 687-9279
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
01/04/2017
Last updated
06/24/2025
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