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Individual

JENNIFER HICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
901 S. HARRILL AVE, WAGONER, OK 74467-5867
(918) 485-0242
(918) 485-0204
Mailing address
1203 SE 3RD ST, WAGONER, OK 74467-5823
(918) 815-9863

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1041C0700X
Clinical Social Worker
7277
OK

Other

Enumeration date
09/14/2016
Last updated
03/15/2024
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