Provider Demographics
NPI:1619393360
Name:HICKS, CYNTHIA SUE (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:SUE
Last Name:HICKS
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 BARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7466
Mailing Address - Country:US
Mailing Address - Phone:614-890-2215
Mailing Address - Fax:
Practice Address - Street 1:263 BARRINGTON DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7466
Practice Address - Country:US
Practice Address - Phone:614-890-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist