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General NPI Number Information
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NPI Number | 1689294126
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Entity Type | Individual
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Provider Name | ASHLEY MCRAE HICKS
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Gender | Female
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Dates
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Enumeration Date | 04/24/2020
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1100 AIRPORT BLVD STE B
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City | PENSACOLA
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State | FL
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Zip | 32504-8622
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Country | US
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Telephone | 850-281-1679
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Fax |
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Provider Business Mailing Address
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Address Line | 9725 DOMINO RD
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City | MILTON
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State | FL
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Zip | 32583-9452
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Country | US
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Telephone | 850-525-5798
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-86372
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License Number State | FL
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