| NPI | 1891883831 |
|---|---|
| Former Name | JENIFER M HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8535) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 8535) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2016-01-11 |