| Doctor Name: | TARRAH A HICKERSON |
| NPI Number: | 1184955700 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 149016132 |
| Business Practice Address: | 2305 Georgia St Louisiana, MO - 633532559 |
| Business Phone Number: | 5737544584 |
| Business Fax Number: | |
| Mailing Address: | 2305 Georgia St, LOUISIANA |
| State: | MO |
| Postal Code: | 633532559 |
| Phone Number: | 5737544584 |
| Fax Number: | |
| NPI Enumeration Date: | 01/21/2010 |
| NPI Last Update Date: | 07/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149016132 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |