Individual
KELLY HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1806 LAKE TEXOMA CIR, ALLEN, TX 75002-4840
(419) 908-5376
Mailing address
1806 LAKE TEXOMA CIR, ALLEN, TX 75002-4840
(419) 908-5376
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01276
KS
224Z00000X
Occupational Therapy Assistant
216528
TX
Other
Enumeration date
01/15/2016
Last updated
09/28/2023
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