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NPI 1992506596

NPI 1992506596 : ALICE INEZ HICKS LSW : USAF ACADEMY, CO

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General NPI Number Information
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    NPI Number           |    1992506596
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    Entity Type          |    Individual 
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    Provider Name        |    ALICE INEZ HICKS LSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/20/2025
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    Last Update Date     |    10/06/2025
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Provider Practice Location Address
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    Address Line         |    5136 COMMUNITY CENTER DR 
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    City                 |    USAF ACADEMY
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    State                |    CO
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    Zip                  |    80840-3002
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    Country              |    US
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    Telephone            |    719-333-5177
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5136 COMMUNITY CENTER DR 
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    City                 |    USAF ACADEMY
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    State                |    CO
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    Zip                  |    80840-3002
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    Country              |    US
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    Telephone            |    425-760-3060
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    150111181
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    License Number State |    IL
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