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Individual

RONNIE HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
9600 CENTRAL AVE SW TRLR 148, ALBUQUERQUE, NM 87121-7681
(562) 507-5687
Mailing address
9600 CENTRAL AVE SW TRLR 148, ALBUQUERQUE, NM 87121-7681
(562) 507-5687

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
171M0000X
NM
172A00000X
Driver
225X00000X
Occupational Therapist
225X0000X
NM
235500000X
Speech/Language/Hearing Specialist/Technologist
23550000X
NM
374U00000X
Home Health Aide
Primary
374U0000X
NM

Other

Enumeration date
01/23/2014
Last updated
02/05/2014
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