Provider Demographics
NPI:1376167395
Name:HERMAN-HICKMAN, ASHLI JILLIAN (LPC)
Entity Type:Individual
Prefix:
First Name:ASHLI
Middle Name:JILLIAN
Last Name:HERMAN-HICKMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ASHLI
Other - Middle Name:JILLIAN
Other - Last Name:HERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:4372 ROYAL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5462
Mailing Address - Country:US
Mailing Address - Phone:214-683-5460
Mailing Address - Fax:
Practice Address - Street 1:4372 ROYAL RIDGE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-5462
Practice Address - Country:US
Practice Address - Phone:214-683-5460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional