Hicks, Shannon

Hicks, Shannon is an sole proprietor health care provider with primary practice located at 10121 Comanche Rd Ne Mitchell Es, Albuquerque NM 87111-3614. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Hicks, Shannon can be contacted via phone (505) 299-1937.

Contact Information

Primary practice address
10121 Comanche Rd Ne Mitchell Es Albuquerque NM 87111-3614
Phone: (505) 299-1937
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 433 New Mexico

Profile Details

NPI number 1154460038
LBN Legal business name Hicks, Shannon
Credentials SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 6th, 2007
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154460038 NPPES
New Mexico MEDICAID Q 5479

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