Individual
LYNN M.H. WICKBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
390 RIVER ST., SPRINGFIELD, VT 05156-2226
(802) 886-4500
(282) 886-4520
Mailing address
390 RIVER ST., SPRINGFIELD, VT 05156-2226
(802) 886-4500
(282) 886-4520
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
042-0009565
VT
2084P0804X
Child & Adolescent Psychiatry Physician
11404
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007840
—
VT
05
—
81263595
—
NH
Enumeration date
09/20/2006
Last updated
11/02/2010
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