MEDICARE: PAULA HICKEL MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1487727574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA HICKEL MS

Provider Business Mailing Address
First Line	:	9222 45TH ST NE
Second Line	:
City	:	CRARY
State	:	ND
Zip	:	58327-9301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	224 4TH ST NW
Second Line	:	SUITE 5
City	:	DEVILS LAKE
State	:	ND
Zip	:	58301-2960
Country	:	US
Telephone Number	:	701-662-6776
Fax Number	:	701-662-6889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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Directions to “ PAULA HICKEL MS” Practice Location

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