Individual
JILLIAN HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
411 S LASALLE ST, DURHAM, NC 27705-3701
(191) 938-3552
Mailing address
410 N FIFTH ST, MEBANE, NC 27302-2508
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6589
NC
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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