| NPI | 1275637613 |
|---|---|
| Former Name | SHANNON ANN HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 18861) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 18861) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2021-09-15 |