Provider Demographics
NPI:1528373610
Name:HICKMAN, DONNA LYNN (MS, LPC INTERN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:HICKMAN
Suffix:
Gender:F
Credentials:MS, LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 ASHBROOK RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-2915
Mailing Address - Country:US
Mailing Address - Phone:469-371-6685
Mailing Address - Fax:
Practice Address - Street 1:3550 PARKWOOD BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1903
Practice Address - Country:US
Practice Address - Phone:469-371-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65712101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health