Individual
KERRY WICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
850 E 300 S STE 1, SALT LAKE CITY, UT 84102-2301
(385) 429-9808
Mailing address
850 E 300 S STE 1, SALT LAKE CITY, UT 84102-2301
(385) 429-9808
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9515461-3501
UT
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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