Individual
MASON HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20370 POE SHOLES DR, BEND, OR 97703-7938
(541) 318-1377
Mailing address
20370 POE SHOLES DR, BEND, OR 97703-7938
(207) 323-4752
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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