Individual
MS. JORDAN DIANE HICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
3389 SUMMIT RIDGE DR, ROCHESTER HILLS, MI 48306-2953
(248) 505-7712
Mailing address
3389 SUMMIT RIDGE DR, ROCHESTER HILLS, MI 48306-2953
(248) 505-7712
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401013783
MI
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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