Individual
MRS. JACQUELINE HUTCHINSON HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2265 COMO AVE, SAINT PAUL, MN 55108-1737
(651) 645-5323
(651) 379-6141
Mailing address
13626 EVERTON AVE, APPLE VALLEY, MN 55124-8081
(612) 859-0205
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20934
MN
Other
Enumeration date
01/04/2016
Last updated
01/04/2016
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