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Individual

MRS. JENNIFER JEANINE HICKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A./CCC

Contact information

Practice address
233 N FOUNTAIN ST, WICHITA, KS 67208-3833
(316) 682-5044
Mailing address
233 N FOUNTAIN ST, WICHITA, KS 67208-3833
(316) 682-5044

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
884
KS

Other

Enumeration date
09/06/2007
Last updated
09/06/2007
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