| NPI | 1679934442 |
|---|---|
| Former Name | AMBER N HICKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16466) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16010-131) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2021-03-31 |