Individual
DEVEN MATTHEW HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
950 E COUNTY LINE RD STE A, RIDGELAND, MS 39157-1928
(601) 308-5117
(601) 308-5103
Mailing address
PO BOX 720610, BYRAM, MS 39272-0610
(601) 308-5117
(601) 308-5103
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3691
MS
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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