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Individual

QUINTARA HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
115 ATRIUM WAY BLDG STE 221, COLUMBIA, SC 29223-6371
(803) 699-8887
Mailing address
1133 FOX TRL, SOUTH BOSTON, VA 24592-6147
(804) 370-3783

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0001278937
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26845
SC

Other

Enumeration date
05/11/2022
Last updated
08/21/2023
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