| Doctor Name: | JOHN B HICKS |
| NPI Number: | 1295025419 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 9941 |
| Business Practice Address: | 18714 River Ford Dr Davidson, NC - 280368816 |
| Business Phone Number: | 7047654880 |
| Business Fax Number: | |
| Mailing Address: | 18714 River Ford Dr, DAVIDSON |
| State: | NC |
| Postal Code: | 280368816 |
| Phone Number: | 7047654880 |
| Fax Number: | |
| NPI Enumeration Date: | 04/08/2011 |
| NPI Last Update Date: | 04/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | 9941 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |