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Individual

VERONICA WICKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTAL

Contact information

Practice address
5635 LAKESHORE RD, FORT GRATIOT, MI 48059-2817
(810) 385-7447
Mailing address
51610 WASHINGTON ST APT 2, NEW BALTIMORE, MI 48047-6614
(810) 580-8251

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202009866
MI

Other

Enumeration date
04/02/2024
Last updated
04/02/2024
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