Individual
ANGELA NICOLE HICKENBOTTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1215 1ST ST, GILROY, CA 95020-4733
(408) 613-4055
Mailing address
1215 1ST ST, GILROY, CA 95020-4733
(408) 613-4055
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT102595
CA
Other
Enumeration date
07/23/2010
Last updated
06/23/2021
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