Individual
MRS. LORI HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1127 QUEENSBOROUGH BLVD STE 104, MT PLEASANT, SC 29464-5431
(843) 216-0290
Mailing address
1127 QUEENSBOROUGH BLVD STE 104, MT PLEASANT, SC 29464-5431
(843) 216-0290
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3899
SC
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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