Individual
TAMMY J HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 337-2438
Mailing address
325 S OAK ST, 103, WINCHESTER, IN 47394-2244
(765) 584-1735
(765) 584-5407
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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