Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | C.1100155 | OH |
NPI | 1003177932 |
---|---|
Provider Name | Ashley H Hicks |
First Address | Dayton, OH 45417-3424 |
Second Address | Dayton, OH 45417-3424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2012 |
Last Update Date | 07/06/2012 |