Individual provider · Type 1 NPI

Brandy T. Hickerson, MED, PSYCHOLOGIST

Professional Counselor · Idabel, OK

NPI number 1104955202 Active

Practice location

17 S Central Ave
Idabel, OK 74745-4625

Call (580) 286-5184 Map

Fax (580) 286-5185

Mailing address

RR 3 Box 474
Broken Bow, OK 74728-9584

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed
School Psychologist 103TS0200XNone listed

Professional Counselor: Definition to come...

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About NPI 1104955202

Brandy T. Hickerson, MED, PSYCHOLOGIST's National Provider Identifier is 1104955202, issued on Mar 5, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Idabel, OK. The record was last updated on Feb 12, 2008.