Individual
CALEB HICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1729 KINNEYS LN STE 101, PORTSMOUTH, OH 45662-3166
(740) 529-2440
Mailing address
411 COURT ST, PORTSMOUTH, OH 45662-3932
(740) 354-6685
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
I.2203992
OH
104100000X
Social Worker
S.1904077
OH
1041C0700X
Clinical Social Worker
Primary
I.2203992
OH
Other
Enumeration date
07/25/2019
Last updated
05/07/2024
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