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General NPI Number Information
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NPI Number | 1255117511
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Entity Type | Individual
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Provider Name | BRITTANY MARIE KICKER LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/04/2023
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Last Update Date | 09/04/2023
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Provider Practice Location Address
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Address Line | 2200 SPACE PARK DR STE 240
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City | HOUSTON
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State | TX
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Zip | 77058-3881
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Country | US
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Telephone | 832-582-4164
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Fax |
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Provider Business Mailing Address
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Address Line | 4227 ARBORETUM DR
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City | PASADENA
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State | TX
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Zip | 77505-3875
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Country | US
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Telephone | 719-231-9866
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 67478
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License Number State | TX
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