Individual
KIMBRIAN HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1403 S LINCOLN AVE STE C, O FALLON, IL 62269-2768
(618) 795-5104
Mailing address
1403 S LINCOLN AVE STE C, O FALLON, IL 62269-2768
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
IL
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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