Individual
MICHAEL HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 OZARK TRAIL DR STE 50, ELLISVILLE, MO 63011-2185
(636) 398-2500
(800) 687-5070
Mailing address
4721 S CLIFF AVE STE 103, INDEPENDENCE, MO 64055-6969
(816) 608-1956
(800) 687-5070
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-354190
—
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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