Individual
SHANAY HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 N WYCOMBE AVE, LANSDOWNE, PA 19050-1644
(445) 208-3871
Mailing address
212 N WYCOMBE AVE APT 1, LANSDOWNE, PA 19050-1644
(445) 208-3871
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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