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Individual

MR. DERWIN L HICKMAN SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. DIV, QMHP-C

Contact information

Practice address
4825 S LABURNUM AVE, RICHMOND, VA 23231-2713
(804) 328-1790
Mailing address
5350 LEWIS RD STE E, SANDSTON, VA 23150-1932

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
792-02-033
VA

Other

Enumeration date
07/05/2022
Last updated
07/05/2022
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