Provider Demographics
NPI:1861813420
Name:DAVIS-HICKS, KATRINA
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:DAVIS-HICKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 N WATER STREET
Mailing Address - Street 2:FLOORS 4 & 5
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3432
Mailing Address - Country:US
Mailing Address - Phone:262-288-5994
Mailing Address - Fax:
Practice Address - Street 1:1433 N WATER STREET
Practice Address - Street 2:FLOORS 4 & 5
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-5320
Practice Address - Country:US
Practice Address - Phone:262-288-5994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-30
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist