| NPI | 1972584480 |
|---|---|
| Former Name | ELIZABETH MARIE HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW015481) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW124204) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2019-08-07 |