Individual
ELIZABETH HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
101 N UNION AVE, SHAWNEE, OK 74801-7067
(405) 275-7100
Mailing address
PO BOX 257, NEWALLA, OK 74857-0257
(405) 990-8847
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5617-P
OK
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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