Individual
JORDAN ELIZABETH HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12225 PULASKI AVE, FORT LEONARD WOOD, MO 65473-1972
(573) 842-2650
Mailing address
12225 PULASKI AVE, FORT LEONARD WOOD, MO 65473-1972
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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