Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003200163 |
---|---|
Provider Name | Mrs. Melissa Gail Hickey |
First Address | West Chester, PA 19382-8409 |
Second Address | Wilmington, DE 19809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 26/03/2015 |