| NPI | 1467697979 |
|---|---|
| Former Name | LINDA JEAN HICKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NJ 37PC00370200) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NJ 37LC00132200) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2008-12-12 |