MEDICARE: SARAH 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
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1285351999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH HICKS

Provider Business Mailing Address
First Line	:	300 INTERNATIONAL PKWY STE 200
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5028
Country	:	US
Telephone Number	:	407-915-7729
Fax Number	:	407-588-6294

Provider Business Practice Location Address
First Line	:	2407 PLANTATION CENTER DR STE 100
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-5418
Country	:	US
Telephone Number	:	704-448-9819
Fax Number	:	704-270-8840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2022
Last Update Date	:	05/12/2025

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Directions to “ SARAH HICKS ” Practice Location

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