Individual
MICHELLE RAE HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ICADC, CADC
Contact information
Practice address
1151 S 4TH ST STE 208, LOUISVILLE, KY 40203-3101
(502) 612-6981
Mailing address
3612 LOCKLEE RD, LOUISVILLE, KY 40214-3831
(502) 612-6981
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
KY
Other
Enumeration date
12/20/2019
Last updated
12/20/2019
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