Provider Demographics
NPI:1477813681
Name:PATTERSON-HICKS, LETICIA ROCHELLE (MSW, LISW)
Entity type:Individual
Prefix:MRS
First Name:LETICIA
Middle Name:ROCHELLE
Last Name:PATTERSON-HICKS
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26311
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-0311
Mailing Address - Country:US
Mailing Address - Phone:937-674-2453
Mailing Address - Fax:
Practice Address - Street 1:5504 HARTLEY CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-2640
Practice Address - Country:US
Practice Address - Phone:937-674-2453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1440227104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker