Individual
MRS. GERALDINE HICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1239 WOODLAND DR STE 110, ELIZABETHTOWN, KY 42701-3723
(270) 312-9655
Mailing address
611 PEACEFUL DR, ELIZABETHTOWN, KY 42701-6465
(270) 317-2880
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
KY3394
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KY 3394
LCSW
KY
Enumeration date
03/11/2009
Last updated
10/18/2013
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