| Doctor Name: | ANNA HICKEY |
| NPI Number: | 1053731067 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 6401013690 |
| Business Practice Address: | 42815 Garfield Rd Suite 210 Clinton Township, MI - 480381143 |
| Business Phone Number: | 5862550499 |
| Business Fax Number: | |
| Mailing Address: | 42815 Garfield Rd, Suite 210 CLINTON TOWNSHIP |
| State: | MI |
| Postal Code: | 480381143 |
| Phone Number: | 5862550499 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2014 |
| NPI Last Update Date: | 02/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 6401013690 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |