Provider Demographics
NPI:1427241678
Name:HICKS, AMY (SLP,)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HICKS
Suffix:
Gender:F
Credentials:SLP,
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:9427 S UNIVERSITY BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-4976
Mailing Address - Country:US
Mailing Address - Phone:720-531-4911
Mailing Address - Fax:928-779-2822
Practice Address - Street 1:9427 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-4976
Practice Address - Country:US
Practice Address - Phone:720-531-4911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP5472235Z00000X
133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist