Individual
GENEVIEVE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
Mailing address
63 MAIN STREET, BROCKTON, MA 02301
(828) 421-4745
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4225
MA
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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