| Doctor Name: | MRS. JEWELL PATRICIA HICKMAN |
| NPI Number: | 1487628491 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 2002010842 |
| Business Practice Address: | 11138 Old Saint Charles Rd Saint Ann, MO - 630742113 |
| Business Phone Number: | 3143440983 |
| Business Fax Number: | 3143440983 |
| Mailing Address: | 9800 Edgefield Dr, SAINT LOUIS |
| State: | MO |
| Postal Code: | 631365419 |
| Phone Number: | 3145032696 |
| Fax Number: | 3143440983 |
| NPI Enumeration Date: | 02/15/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2002010842 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |