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Individual

COREY HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. ED. CCC-SLP

Contact information

Practice address
11512 LAKE MEAD AVENUE SUITE 604, JACKSONVILLE, FL 32256
(904) 652-5408
Mailing address
653 MONUMENT ROAD APT 1102, JACKSONVILLE, FL 32225
(229) 798-3848

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 12067
FL

Other

Enumeration date
10/23/2014
Last updated
10/23/2014
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