Individual
BRENETTA HICKS-JONES
Active
Individual
BRENETTA HICKS-JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-3839
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH-3938
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
11/17/2011
Last updated
11/17/2011
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