Individual
MR. MARK EDMUND HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5227 DENTON DR, DALLAS, TX 75235-8304
(214) 403-7675
Mailing address
5227 DENTON DR, DALLAS, TX 75235-8304
(214) 403-7675
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S29456
TX
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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