Individual
TARA ELIZABETH HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
390 HODGSON RD, COLUMBIA FALLS, MT 59912-9063
(406) 871-6738
Mailing address
325 7TH AVE W, KALISPELL, MT 59901-4761
(406) 407-6239
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30703
MT
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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