Individual
LACY HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
129 KELLY ST, POOLER, GA 31322-2611
(912) 659-5866
Mailing address
129 KELLY ST, POOLER, GA 31322-2611
(912) 659-5866
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC008360
GA
Other
Enumeration date
01/06/2017
Last updated
01/06/2017
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