Individual
NANNETTE LOUISE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
8727 W WETHERSFIELD RD, PEORIA, AZ 85381-8111
(602) 509-4675
(602) 252-0830
Mailing address
8727 W WETHERSFIELD RD, PEORIA, AZ 85381-8111
(602) 509-4675
(602) 252-0830
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC11455
AZ
Other
Enumeration date
09/26/2013
Last updated
10/15/2013
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