Individual
SHANTI LUNA HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17978 SR 55, BAKER, WV 26801
(304) 897-5915
Mailing address
PO BOX 97, BAKER, WV 26801-0097
(304) 897-5915
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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