Individual
KYLE ELMO HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
338 W 300 N STE 6, HYDE PARK, UT 84318-4044
(435) 241-7105
Mailing address
338 W 300 N STE 6, HYDE PARK, UT 84318-4044
(435) 241-7105
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11767393-3501
UT
Other
Enumeration date
12/13/2020
Last updated
03/15/2024
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