Individual
BREANNA SHAWNTA HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 PETERMAN DR STE C, ALEXANDRIA, LA 71301-3432
(318) 240-3779
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(925) 264-1902
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
CA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
LA
Other
Enumeration date
10/21/2017
Last updated
07/02/2025
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