Individual
DOMINIQUE LEEANN HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
501 E GREEN DR, HIGH POINT, NC 27260
(336) 641-7654
(336) 641-3210
Mailing address
117 MEADOWOOD ST APT E, GREENSBORO, NC 27409-2357
(336) 493-9875
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C012368
NC
1041C0700X
Clinical Social Worker
P011631
NC
Other
Enumeration date
06/14/2017
Last updated
08/06/2019
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