| NPI | 1205201860 |
|---|---|
| Former Name | ROMELL HICKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103K00000X Behavior Analyst | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2019-10-10 |