Provider Demographics
NPI:1073555413
Name:HICKEY, PATRICIA LYNNE (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNNE
Last Name:HICKEY
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 JEFFERSON RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3388
Mailing Address - Country:US
Mailing Address - Phone:508-520-8667
Mailing Address - Fax:
Practice Address - Street 1:50 RICE ST
Practice Address - Street 2:WHS ATHLETIC DEPT
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-6007
Practice Address - Country:US
Practice Address - Phone:781-446-6290
Practice Address - Fax:781-446-6289
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2732255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer