Hickerson, Alonzo Anthony

Hickerson, Alonzo Anthony is an sole proprietor health care provider with primary practice located at 3100 Mill St Suite 206, Reno NV 89502-2259. He recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as his primary health care specialty. Hickerson, Alonzo Anthony can be contacted via phone (775) 348-8048.

Contact Information

Primary practice address
3100 Mill St Suite 206 Reno NV 89502-2259
Fax: (775) 348-8048
Website:

Health care specialties

Profile Details

NPI number 1811294721
LBN Legal business name Hickerson, Alonzo Anthony
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 12th, 2011
Last updated Feb 12th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811294721 NPPES
Nevada MEDICAID 100511515

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