Individual
MS. KAONI HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10340 AVELAR RIDGE DR, RIVERVIEW, FL 33578-7563
(321) 431-6005
Mailing address
PO BOX 961, RIVERVIEW, FL 33568-0961
(863) 393-3180
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
FL
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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