person
Irene Marie Hicks, CATC
Addiction (Substance Use Disorder) Counselor in San Clemente, California
NPI 1649365933

Irene Marie Hicks is an Addiction (Substance Use Disorder) Counselor based in San Clemente, CA and is specialized in Addiction (Substance Use Disorder). Irene Marie Hicks practices in San Clemente, CA and has the professional credentials of CATC. The NPI Number for Irene Marie Hicks is 1649365933 and holds a License No. 061337 (California).

The current practice location address for Irene Marie Hicks is 101 Avenida Serra, San Clemente, CA and can be reached out via phone at 949-366-9210 and via fax at 949-498-5706.

Location: 101 Avenida Serra, San Clemente, CA, 92672
person
Provider Profile Details
NPI Number
1649365933
Provider Name
Irene Marie Hicks
Credential
CATC
Provider Entity Type
Individual
Gender
Female
Address
101 Avenida Serra, San Clemente, CA, 92672
Phone Number
949-366-9210
Fax Number
949-498-5706
Provider Enumeration Date
10/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101YA0400X 01 CA COUNSELOR
institution
Provider Business Practice Location Address Details
Address
101 Avenida Serra
City
State
Zip
92672
Phone Number
949-366-9210
Fax Number
949-498-5706
person
Provider Business Mailing Address Details
Address
101 Avenida Serra
City
State
Zip
92672
Phone Number
949-366-9210
Fax Number
949-498-5706
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
061337 (California)
Definition
Definition to come...
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