Individual
DUSTIN HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
213 E CHESTNUT ST, MOUNT VERNON, OH 43050-3404
(740) 326-9255
Mailing address
213 E CHESTNUT ST, MOUNT VERNON, OH 43050-3404
(740) 326-9255
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA175807
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/29/2020
Last updated
03/30/2021
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