Individual
MS. TERESA R HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CEO
Contact information
Practice address
3350 SWEETWATER RD APT 813, LAWRENCEVILLE, GA 30044-6573
(678) 328-0107
Mailing address
3350 SWEETWATER RD APT 813, LAWRENCEVILLE, GA 30044-6573
(678) 328-0107
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
059400425
GA
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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