Individual
CONSUELO MARIA HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
19211 BILTMORE ST, DETROIT, MI 48235-2442
(734) 353-5224
Mailing address
19211 BILTMORE ST, DETROIT, MI 48235-2442
(734) 353-5224
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703089147
MI
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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