Most Relevant Information
Provider Data
| NPI Number: | 1003296427 |
| Provider Name: | TRACY HICKS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/01/2015 |
| Last Updated: | 06/01/2015 |
Provider Practice Location
1644 JACKSON ST
BARNWELL
SC
298122156
Practice Location Phone/Fax
| Phone: | 8035411245 |
| Fax: | 8035411247 |
Provider Mailing Location
1644 JACKSON ST
BARNWELL
SC
298122156
Provider Mailing Phone/Fax
| Phone: | 8035411245 |
| Fax: | 8035411247 |