NPI 1437653649
Tyra Jameese Hicks, MAQMHP
Practice location
- Address
- 410 Walnut St, Petersburg, VA 23803-5763
- Phone
- (804) 835-9959
Registered specialties
Case Manager/Care Coordinator
Primary
Registry record
- NPI
- 1437653649
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 21 Mar 2018
- Record last updated
- 15 Apr 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.