Provider Demographics
NPI:1508094483
Name:HICKS, SHARON (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:HICKS
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 413
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010
Mailing Address - Country:US
Mailing Address - Phone:610-299-6210
Mailing Address - Fax:
Practice Address - Street 1:311 E BALTIMORE PIKE
Practice Address - Street 2:SUITE 100 A
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3507
Practice Address - Country:US
Practice Address - Phone:610-892-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist