Individual
ALLISON WICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
885 HAMPSHIRE RD, BAY SHORE, NY 11706-7631
(631) 968-1250
Mailing address
161 WASHINGTON AVE, HOLTSVILLE, NY 11742-1050
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
029085
NY
Other
Enumeration date
01/21/2019
Last updated
09/04/2019
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