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General NPI Number Information
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NPI Number | 1407510845
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Entity Type | Individual
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Provider Name | MRS. SHANNON HICKS
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Gender | Female
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 15003 HIGHWAY 6 STE 108
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City | ROSHARON
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State | TX
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Zip | 77583-7371
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Country | US
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Telephone | 281-710-4980
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Fax | 346-326-5898
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Provider Business Mailing Address
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Address Line | 15003 HIGHWAY 6 STE 108
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City | ROSHARON
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State | TX
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Zip | 77583-7371
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Country | US
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Telephone | 281-710-4980
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Fax | 346-326-5598
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 4451
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License Number State | TX
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