Individual
MRS. SANDRA JEANNE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
5 LEXINGTON DR, CLARKSVILLE, TN 37042-3611
(931) 802-0956
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-163915
TN
Other
Enumeration date
03/17/2023
Last updated
03/17/2023
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