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1013589928
BLAKE HICKS
BOWLING GREEN, KY
NPI
1013589928
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: TN RBT-21-175322)
Enumeration Date
2021-07-12
Last Update Date
2021-07-12
Business Address
BLAKE HICKS RBT
2427 RUSSELLVILLE RD
BOWLING GREEN, KY 42101-3980
Phone number: 270-936-7472
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Mailing Address
BLAKE HICKS RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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