Idella Marie Hicks

NPI #1417545252 in Inkster, Michigan

Provider Information

NPI Number: 1417545252
Entity Type: Individual
Name: Idella Marie Hicks
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Assisted Living Facility - Assisted Living, Mental Illness
Enumeration Date: Jan 7, 2021
Last Updated: Jan 7, 2021

Practice Location

Address: 4183 WAYLAND CT
City: Inkster
State: Michigan
ZIP Code: 48141-2818
Phone: (330) 951-9865

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility - Assisted Living, Mental Illness — Assisted Living, Mental Illness	3104A0625X	Primary

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