Individual
BETHANY ERIN HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
629 GALLAHER RD, KINGSTON, TN 37763-4215
(865) 376-3416
(865) 376-3532
Mailing address
323 BRITTS DR, LENOIR CITY, TN 37772-6992
(865) 789-0854
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3267
TN
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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