MISS Tina Marie Hickey
NPI #1457649014 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1457649014
- Entity Type
- Individual
- Name
- MISS Tina Marie Hickey
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Early Intervention Provider Agency
- Enumeration Date
- Jul 18, 2011
- Last Updated
- Jul 18, 2011
Practice Location
- Address
- 647 S PRAIRIE ST
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-2870
- Phone
- (217) 245-5095
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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