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Individual

MRS. MAYA ELAINE HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,LAT,ATC

Contact information

Practice address
11221 GALLERIA AVE STE 101, RALEIGH, NC 27614-8137
(919) 645-9410
Mailing address
6308 DRY FORK LN, RALEIGH, NC 27617-7615
(919) 417-6832

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-5707
NC

Other

Enumeration date
07/12/2021
Last updated
07/23/2024
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