Individual
CARRIE JL HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, MS
Contact information
Practice address
748 14TH AVE, LONGVIEW, WA 98632-2315
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-8455
(360) 200-5419
(360) 200-3736
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG61169681
WA
101YM0800X
Mental Health Counselor
Primary
MC61257898
WA
Other
Enumeration date
06/01/2021
Last updated
04/21/2022
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