Individual
WANDA J LICKTEIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CHT
Contact information
Practice address
1701 CURVE CREST BLVD W, SUITE 104, STILLWATER, MN 55082-6044
(651) 439-8807
(651) 439-0232
Mailing address
4200 DAHLBERG DR, SUITE 300, GOLDEN VALLEY, MN 55422-4840
(952) 512-5600
(952) 512-5651
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
103078
MN
Other
Enumeration date
08/23/2006
Last updated
08/22/2016
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