Provider Demographics
NPI:1639520067
Name:HICKS, QUE'MEICIA TENEICE (MED)
Entity Type:Individual
Prefix:
First Name:QUE'MEICIA
Middle Name:TENEICE
Last Name:HICKS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2882 TALL OAKS CT APT 14
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-4115
Mailing Address - Country:US
Mailing Address - Phone:313-221-4600
Mailing Address - Fax:
Practice Address - Street 1:2882 TALL OAKS CT APT 14
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-4115
Practice Address - Country:US
Practice Address - Phone:313-221-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other