Individual
DOMINIC HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
14235 RIATA LN, DALLAS, TX 75253-4930
(972) 768-1569
Mailing address
14235 RIATA LN, DALLAS, TX 75253-4930
(972) 768-1569
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216711
TX
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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