| NPI | 1730506924 |
|---|---|
| Other Name | ANDREA HICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NY 024517) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NY 001958) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |