Individual
MS. KATHY L HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1086 DONAL DR, MANSFIELD, OH 44907-2648
(419) 270-5053
Mailing address
1086 DONAL DR, MANSFIELD, OH 44907-2648
(419) 270-5053
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
020504
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020504
—
OH
Enumeration date
02/17/2020
Last updated
02/17/2020
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