Individual
DANIELLE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 NORTHSIDE XING, MACON, GA 31210-2376
(855) 832-6727
Mailing address
1218 SUNSET AVE, PERRY, GA 31069-2621
(478) 244-1793
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-279104
GA
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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