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General NPI Number Information
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NPI Number | 1124810502
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Entity Type | Individual
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Provider Name | BRIANNA HICKEY
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 689 W MAIN ST
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City | FREEHOLD
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State | NJ
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Zip | 07728-2511
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Country | US
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Telephone | 732-431-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 611 BORDENTOWN AVE UNIT 305
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City | SOUTH AMBOY
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State | NJ
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Zip | 08879-2176
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Country | US
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Telephone | 201-248-2593
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 41YS01207100
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License Number State | NJ
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