Individual
MRS. SUZANNE HICKS GRANTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP APRN BC
Contact information
Practice address
1101 S CAPITAL OF TEXAS HWY, BLDG A SUITE 200, AUSTIN, TX 78746
(523) 617-6746
(512) 329-5522
Mailing address
1101 S CAPITAL OF TEXAS HWY, BLDG A SUITE 200, AUSTIN, TX 78746-6400
(512) 617-6746
(512) 329-5522
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
720359
TX
Other
Enumeration date
11/09/2005
Last updated
05/17/2024
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