Provider Demographics
NPI:1588956114
Name:HICKS, ROBIN JOLENE (SLP)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:JOLENE
Last Name:HICKS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N41W22672 SUNDER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-2266
Mailing Address - Country:US
Mailing Address - Phone:815-499-2744
Mailing Address - Fax:
Practice Address - Street 1:N41W22672 SUNDER CREEK DR
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-2266
Practice Address - Country:US
Practice Address - Phone:815-499-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3475-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist