Individual
KRISTEN K WICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3700 S 1ST ST, AUSTIN, TX 78704-7046
(512) 735-2430
Mailing address
1607 WILLOW ST, AUSTIN, TX 78702-4405
(512) 560-8332
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
76237
TX
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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