Individual
CORY JOSEPH BICKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
11503 PARSONS RD, MANOR, TX 78653-5220
(512) 278-4923
Mailing address
6903 PINTO CV, LAGO VISTA, TX 78645-4920
(225) 936-5954
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15005
TX
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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