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General NPI Number Information
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NPI Number | 1831998384
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Entity Type | Individual
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Provider Name | DAMIAN HICKS
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Gender | Male
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2270 LOSEE RD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-4109
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Country | US
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Telephone | 725-260-3599
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Fax |
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Provider Business Mailing Address
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Address Line | 509 DOLPHIN POINT CT
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89081-2313
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Country | US
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Telephone | 702-339-7865
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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