Individual
MRS. JULIE ANN WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1709 10TH ST, WICHITA FALLS, TX 76301-5010
(940) 500-8859
(940) 696-6210
Mailing address
PO BOX 8266, WICHITA FALLS, TX 76307-8266
(940) 500-8859
(940) 696-6210
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104866
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005329003
—
TX
01
—
8T2729
BCBS PROVIDER #
TX
Enumeration date
12/06/2005
Last updated
03/08/2017
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