Individual
PHYLIS HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LISW
Contact information
Practice address
105 ALERO CIR NE, RIO RANCHO, NM 87124-0807
(505) 702-8978
(505) 702-8920
Mailing address
105 ALERO CIR NE, RIO RANCHO, NM 87124-0807
(505) 702-8978
(505) 702-8920
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-07026
NM
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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