Individual
LEEEVA L HICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
4800 NAVY RD, SUITE 3, MILLINGTON, TN 38053-1914
(901) 504-9915
(901) 504-9915
Mailing address
4800 NAVY RD, SUITE 3, MILLINGTON, TN 38053-1914
(901) 504-9915
(901) 504-9915
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
171W00000X
Contractor
—
—
Other
Enumeration date
02/01/2007
Last updated
01/02/2015
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