Individual
MR. JEREMIAH WAYNE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, CAADC, CCDPD
Contact information
Practice address
1993 CATO AVE, STATE COLLEGE, PA 16801-2754
(814) 231-8820
(814) 231-8857
Mailing address
1993 CATO AVE, STATE COLLEGE, PA 16801-2754
(814) 231-8820
(814) 231-8857
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW017437
PA
Other
Enumeration date
01/11/2013
Last updated
10/18/2017
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