Provider Demographics
NPI:1679291769
Name:HICKS, CASSANDRA ANN (PHD)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ANN
Last Name:HICKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:ANN
Other - Last Name:PALSMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:486 N DIJON CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-1946
Mailing Address - Country:US
Mailing Address - Phone:928-862-0186
Mailing Address - Fax:
Practice Address - Street 1:850 W VALENCIA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85706-7619
Practice Address - Country:US
Practice Address - Phone:520-741-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool