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Individual

ALICIA HICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6266 WISCASSET PKWY NW, DALLAS, GA 30157-6549
(770) 881-2041
Mailing address
6266 WISCASSET PKWY NW, DALLAS, GA 30157-6549
(770) 881-2041

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
GA

Other

Enumeration date
10/14/2020
Last updated
10/14/2020
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