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General NPI Number Information
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NPI Number | 1588520456
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Entity Type | Individual
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Provider Name | CONNER S HICKS
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Gender |
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1050 N SHOOP AVE
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City | WAUSEON
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State | OH
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Zip | 43567-1821
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Country | US
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Telephone | 567-343-6068
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 293
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City | WAUSEON
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State | OH
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Zip | 43567-0293
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Country | US
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Telephone |
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C.2507258
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License Number State | OH
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