Provider Information for 1437467719
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Mr. WILLIAM CHARLES HICKS Mental Health Counse
Sex: Male
NPI: 1437467719
Last Updated: 2014-12-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1437467719 | ||||||||||||||||
| Enumeration Date | 2010-09-20 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1724 VILLAGE WAY SUITE A ORANGE PARK, FL 32073 United States Phone: 904-269-0886 | Fax:904-269-0499 | ||||||||||||||||
| Primary Practice Address | 1724 VILLAGE WAY SUITE A ORANGE PARK, FL 32073 United States Phone: 904-269-0886 | Fax:904-269-0499 | ||||||||||||||||
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