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NPI Code Detail

MEDICARE: MR. LATRON P HICKS

MEDICARE:  MR. LATRON P HICKS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1871204453
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LATRON P HICKS
Provider Business Mailing Address
First Line : 9947 PIPESTONE ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89141-8667
Country : US
Telephone Number : 702-601-4647
Fax Number :
Provider Business Practice Location Address
First Line : 4375 LAS VEGAS BLVD N
Second Line :
City : LAS VEGAS
State : NV
Zip : 89115-0587
Country : US
Telephone Number : 702-601-4647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2022
Last Update Date : 12/05/2022

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Directions to “ MR. LATRON P HICKS ” Practice Location

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