Individual
HEATHER L. HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2025 13TH ST, ASHLAND, KY 41101-3517
(606) 465-9736
Mailing address
2025 13TH ST, ASHLAND, KY 41101-3517
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT.006778
OH
225X00000X
Occupational Therapist
Primary
R4098
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000474318
OHIO MEDICAID UNISON
OH
05
—
0058011
—
OH
01
—
310917085167
OHIO MEDICAID CARESOURCE
OH
05
—
3810022144
—
WV
Enumeration date
01/25/2011
Last updated
03/29/2012
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