Healthcare Provider Details

I. General information

NPI: 1861515348
Provider Name (Legal Business Name): GRETCHEN SPRING HICKS MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 DINEEN DR
LITTLE ROCK AR
72206-5820
US

IV. Provider business mailing address

22108 PHILLIP DR
LITTLE ROCK AR
72206-9206
US

V. Phone/Fax

Practice location:
  • Phone: 501-897-2171
  • Fax:
Mailing address:
  • Phone: 501-351-4221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number703
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: