Individual
KARISSA HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6442 CLUB DR, GILMER, TX 75645-7093
(903) 787-1275
Mailing address
6442 CLUB DR, GILMER, TX 75645-7093
(903) 787-1275
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
214436
TX
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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