| Doctor Name: | BETHANY ERIN HICKS |
| NPI Number: | 1154699122 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA CCC-SLP |
| License Number: | 3267 |
| Business Practice Address: | 629 Gallaher Rd Kingston, TN - 377634215 |
| Business Phone Number: | 8653763416 |
| Business Fax Number: | 8653763532 |
| Mailing Address: | 323 Britts Dr, LENOIR CITY |
| State: | TN |
| Postal Code: | 377726992 |
| Phone Number: | 8657890854 |
| Fax Number: | |
| NPI Enumeration Date: | 12/06/2011 |
| NPI Last Update Date: | 12/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 3267 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |