NPI 1659558005

Shannon Troy Hicks, CTRS

Practitioner Recreation Therapist Memphis, TN

Practice location

Address: 1030 Jefferson Ave, Memphis, TN 38104-2127
Phone: (901) 523-8990
Mailing address: 7820 Freehold Dr, Memphis, TN 38125-3254

Registered specialties

Recreation Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225800000X Licence 38504 (LA)

Other Recreation Therapist providers in Tennessee →

Registry record

NPI: 1659558005
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jan 2008
Record last updated: 29 Jan 2008

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.