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General NPI Number Information
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NPI Number | 1356528715
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Entity Type | Individual
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Provider Name | ANDREA B HICKMAN M.ED, LMHC
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Gender | Female
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 10/24/2013
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Provider Practice Location Address
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Address Line | 20174 FRONT ST NE C/O FRONT STREET CLINIC
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City | POULSBO
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State | WA
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Zip | 98370-7445
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Country | US
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Telephone | 503-329-8633
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Fax |
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Provider Business Mailing Address
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Address Line | 4510 PICKEREL CIR NW APARTMENT A
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City | SILVERDALE
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State | WA
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Zip | 98315-9765
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Country | US
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Telephone | 503-329-8633
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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