Provider Demographics
NPI:1003598665
Name:HICKS, ABIGAIL (DPT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HICKS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17094 AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3400
Mailing Address - Country:US
Mailing Address - Phone:225-677-8400
Mailing Address - Fax:225-677-8484
Practice Address - Street 1:17094 AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3400
Practice Address - Country:US
Practice Address - Phone:225-677-8400
Practice Address - Fax:225-677-8484
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11526225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist