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NPI Code Detail

MEDICARE: DEVONNIE HICKS

MEDICARE: DEVONNIE HICKS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1164285961
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVONNIE HICKS
Provider Business Mailing Address
First Line : 224 W 35TH ST STE 500
Second Line :
City : NEW YORK
State : NY
Zip : 10001-2538
Country : US
Telephone Number : 833-646-3222
Fax Number : 833-646-3222
Provider Business Practice Location Address
First Line : 295 INTERLOCKEN BLVD STE 250
Second Line :
City : BROOMFIELD
State : CO
Zip : 80021-8040
Country : US
Telephone Number : 833-646-3222
Fax Number : 833-646-3222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2024
Last Update Date : 02/05/2024

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Directions to “ DEVONNIE HICKS ” Practice Location

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