Individual
MRS. WENDY LYN WICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,LPC,SAC
Contact information
Practice address
13035 W BLUEMOUND RD, SUITE 100, BROOKFIELD, WI 53005-8001
(262) 408-1125
Mailing address
13035 W BLUEMOUND RD, SUITE 100, BROOKFIELD, WI 53005-8001
(262) 408-1125
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15465-131
WI
101YP2500X
Professional Counselor
Primary
3937-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174717094
—
WI
Enumeration date
09/04/2007
Last updated
11/19/2009
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