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General NPI Number Information
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NPI Number | 1104328558
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Entity Type | Organization
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Legal Business Name | SONJA R. POITIER-HICKMAN, LCSW, LLC
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 703 THIMBLE SHOALS BLVD STE A-3
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4536
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Country | US
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Telephone | 757-778-3699
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Fax |
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Provider Business Mailing Address
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Address Line | 703 THIMBLE SHOALS BLVD STE A-3
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4536
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Country | US
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Telephone | 757-778-3699
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SONJA POITIER-HICKMAN
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Credential | LCSW
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Telephone | 757-778-3699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 090400967
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License Number State | VA
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