Individual
CARLY ANN WICKSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2255 SW 37TH WAY, GAINESVILLE, FL 32607-4484
(386) 882-2053
Mailing address
2255 SW 37TH WAY, GAINESVILLE, FL 32607-4484
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VFM244898
FLORIDA HEALTH CARE PLANS
FL
Enumeration date
10/10/2022
Last updated
10/10/2022
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