Individual
DR. MARY ROSE HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
9205 W CENTER ST, SUITE 209, MILWAUKEE, WI 53222-4548
(414) 257-3044
Mailing address
6215 S 39TH ST, GREENFIELD, WI 53221-4521
(414) 737-4655
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1430-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40668
NATIONAL REGISTER
WI
Enumeration date
05/09/2007
Last updated
07/08/2007
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