Organization
MARTHA WIKE, PH.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA WIKE PH.D. (PRESIDENT)
(865) 584-6111
Entity
Organization
Contact information
Practice address
4006 SUTHERLAND AVE, KNOXVILLE, TN 37919-5103
(865) 584-6111
Mailing address
PO BOX 11423, KNOXVILLE, TN 37939-1423
(865) 584-6111
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1710
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518034
—
TN
Enumeration date
05/02/2013
Last updated
05/02/2013
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