Individual
MARY MARGARET HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8407 SW 46TH AVE, PORTLAND, OR 97219-3423
(503) 568-1846
Mailing address
8407 SW 46TH AVE, PORTLAND, OR 97219-3423
(503) 568-1846
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C6943
OR
101YP2500X
Professional Counselor
Primary
C6943
OR
Other
Enumeration date
08/25/2006
Last updated
10/08/2023
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