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General NPI Number Information
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NPI Number | 1477813681
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Entity Type | Individual
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Provider Name | LETICIA ROCHELLE PATTERSON-HICKS MSW, LISW
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Gender | Female
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 5504 HARTLEY CT
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City | DAYTON
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State | OH
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Zip | 45424-2640
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Country | US
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Telephone | 937-674-2453
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26311
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City | TROTWOOD
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State | OH
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Zip | 45426-0311
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Country | US
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Telephone | 937-674-2453
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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 | I.1440227
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1440227
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License Number State | OH
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