Individual
BETH HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 455-4860
Mailing address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 455-4860
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
4651
AZ
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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