Individual
PAMELA S WICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
651 STATE ST, FRANKLIN, IN 46131-2552
(317) 736-6414
Mailing address
220 ARDMOOR DR, WHITELAND, IN 46184-1432
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000189A
IN
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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