Provider Demographics
NPI:1427502889
Name:HICKS, NASASKYIA ROKENZA
Entity type:Individual
Prefix:MS
First Name:NASASKYIA
Middle Name:ROKENZA
Last Name:HICKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 GRIFFIN MILL RD
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-6929
Mailing Address - Country:US
Mailing Address - Phone:864-397-1415
Mailing Address - Fax:
Practice Address - Street 1:1400 GRIFFIN MILL RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-6929
Practice Address - Country:US
Practice Address - Phone:864-397-1415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool