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Individual

ALEXANDER HICKEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10273 YELLOW CIRCLE DR, MINNETONKA, MN 55343-9144
(952) 215-3753
Mailing address
12005 41ST AVE N APT 117, PLYMOUTH, MN 55441-1234
(801) 234-9013

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
11/02/2021
Last updated
11/05/2024
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