Individual
MISS AMANDA RENEA HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6601 PHOENIX AVE STE B, FORT SMITH, AR 72903-5092
(479) 785-9091
Mailing address
1 CHILDRENS WAY # 512-39, LITTLE ROCK, AR 72202-3500
(501) 526-8700
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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