Individual
KATHLEEN M HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4329 MAHONING AVE NW STE B, WARREN, OH 44483-1974
(330) 847-7819
(330) 847-8192
Mailing address
6131 MILL CREEK BLVD, BOARDMAN, OH 44512-2723
(330) 770-5263
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT010250
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3092166
—
OH
Enumeration date
06/29/2010
Last updated
05/27/2021
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