Individual
GEORGIA HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
414 HAWLEY AVE # 2, SYRACUSE, NY 13203-2410
(719) 396-9264
Mailing address
414 HAWLEY AVE # 2, SYRACUSE, NY 13203-2410
(719) 396-9264
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001357-1
NY
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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