Provider Demographics
NPI:1598706236
Name:HICKS, MOLLY M (AUD)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:M
Last Name:HICKS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 WINGED FOOT CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-6083
Mailing Address - Country:US
Mailing Address - Phone:803-746-4871
Mailing Address - Fax:
Practice Address - Street 1:1261 WINGED FOOT CT
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-6083
Practice Address - Country:US
Practice Address - Phone:803-746-4871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6098231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1052OtherNC HEARING AID DEALERS BD