Individual
SETH HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHP-T, MA IN HS
Contact information
Practice address
66 IVY KNOLL DR, GLADYS, VA 24554-2505
(661) 747-5481
Mailing address
66 IVY KNOLL DR, GLADYS, VA 24554-2505
(661) 747-5481
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
VA
251S00000X
Community/Behavioral Health Agency
0734012182
VA
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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