Individual
KELLY ANN WICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
550 RT. 30, NEWFANE, VT 05345
(802) 365-7001
Mailing address
1513 ABBOTT RD, WINDHAM, VT 05359-9676
(802) 365-7001
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0057705
VT
Other
Enumeration date
06/03/2010
Last updated
06/03/2010
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