Provider Demographics
NPI:1568501450
Name:HICKEY, ELIZABETH A (CMT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:HICKEY
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-3621
Mailing Address - Country:US
Mailing Address - Phone:848-992-0551
Mailing Address - Fax:
Practice Address - Street 1:2139 ROBIN LN
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-3621
Practice Address - Country:US
Practice Address - Phone:848-992-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath