Individual
MRS. VICKIE DARLENE HICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1079 BROOKS ROAD, SUMMERVILLE, GA 30747
(706) 936-9919
Mailing address
5050 HIGHWAY 100, SUMMERVILLE, GA 30747
(706) 936-9919
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT003116
GA
225XP0200X
Pediatric Occupational Therapist
Primary
OT003116
GA
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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