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General NPI Number Information
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NPI Number | 1568629715
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Entity Type | Organization
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Legal Business Name | LAURA HICKOK, PH.D., P.C.
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 4405 E WEST HWY SUITE 312
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City | BETHESDA
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State | MD
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Zip | 20814-4522
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Country | US
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Telephone | 301-654-2322
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Fax |
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Provider Business Mailing Address
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Address Line | 4405 E WEST HWY SUITE 312
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City | BETHESDA
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State | MD
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Zip | 20814-4522
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Country | US
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Telephone | 301-654-2322
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAURA HICKOK
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Credential | PH.D.
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Telephone | 301-654-2322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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