Individual
TAMARA HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
Mailing address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
270132
OH
Other
Enumeration date
07/31/2019
Last updated
04/24/2020
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