Provider Demographics
NPI:1548595952
Name:HICKS, ELIZABETH ANN (MED)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:HICKS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:MICHAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:66 WYNNE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-2051
Mailing Address - Country:US
Mailing Address - Phone:412-877-4580
Mailing Address - Fax:
Practice Address - Street 1:1011 BINGHAM ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1101
Practice Address - Country:US
Practice Address - Phone:412-235-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-03
Last Update Date:2009-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor