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Individual

MELANIE HICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP, MCD, CCC

Contact information

Practice address
508 E FREE ST, WALNUT RIDGE, AR 72476-2804
(870) 886-3482
Mailing address
1722 HIGHWAY 91, WALNUT RIDGE, AR 72476-8402

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#562
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119411721
AR
Enumeration date
08/19/2008
Last updated
08/19/2008
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