Provider Demographics
NPI:1720370984
Name:PRIETO HICKS, XIMENA ALEJANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:XIMENA
Middle Name:ALEJANDRA
Last Name:PRIETO HICKS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1035 PROPRIETORS RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3284
Mailing Address - Country:US
Mailing Address - Phone:614-785-1115
Mailing Address - Fax:614-785-0095
Practice Address - Street 1:1035 PROPRIETORS RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3284
Practice Address - Country:US
Practice Address - Phone:614-785-1115
Practice Address - Fax:614-785-0095
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH351233312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35123331OtherSTATE MEDICAL BOARD OF OHIO