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Individual

KENNETH VAN HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCDC

Contact information

Practice address
4101 S MEDFORD DR, LUFKIN, TX 75901-5633
(936) 633-5676
(936) 633-5695
Mailing address
4101 S MEDFORD DR, LUFKIN, TX 75901-5633
(936) 633-5676
(936) 633-5695

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18196
TX

Other

Enumeration date
04/21/2010
Last updated
04/21/2010
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