Individual
MRS. FLORENCE DENISE RAINEY HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 LAMBETH DR, COLUMBIA, MO 65202-2462
(573) 219-1414
(573) 256-1915
Mailing address
1024 VEGAS DR, COLUMBIA, MO 65203-1450
(573) 219-1414
(573) 256-1519
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/29/2008
Last updated
08/04/2011
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