Individual
MRS. CARMEN E HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC
Contact information
Practice address
2708 PATTERSON RD, GRAND JUNCTION, CO 81506
(970) 243-9537
Mailing address
2708 PATTERSON RD, GRAND JUNCTION, CO 81506
(970) 243-9537
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2631
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2631
DORA
CO
05
—
508911
—
CO
Enumeration date
03/30/2007
Last updated
07/08/2007
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