| NPI | 1801126891 |
|---|---|
| Former Name | MELODY HICKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY28235) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA RPS2012110) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NONE) | |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2019-04-18 |