Provider Demographics
NPI:1528293461
Name:HICKS, SAUNA L
Entity type:Individual
Prefix:MS
First Name:SAUNA
Middle Name:L
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 1:623 BEECHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-6236
Mailing Address - Country:US
Mailing Address - Phone:904-358-1211
Mailing Address - Fax:904-358-1551
Practice Address - Street 1:623 BEECHWOOD ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-6236
Practice Address - Country:US
Practice Address - Phone:904-358-1211
Practice Address - Fax:904-358-1551
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health