Individual
ELISA MARIE HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
403 KRUGER ST, WHEELING, WV 26003-5126
(304) 905-8142
Mailing address
403 KRUGER ST, WHEELING, WV 26003-5126
(304) 905-8142
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00944200
WV
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
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