Individual
BEVERLY W HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
378 TABOR RD, FORT VALLEY, GA 31030-6024
(478) 971-4684
Mailing address
378 TABOR RD, FORT VALLEY, GA 31030-6024
(478) 971-4684
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RN081233
GA
Other
Enumeration date
06/27/2012
Last updated
06/27/2012
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