Individual
DONTAE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4529 BRECCIA LN, LAKELAND, FL 33811-3118
(863) 617-3477
Mailing address
4529 BRECCIA LN, LAKELAND, FL 33811-3118
(863) 617-3477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW25161
FL
Other
Enumeration date
07/30/2025
Last updated
07/30/2025
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