Individual
MRS. JACLYN NICOL WICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5904 SUMMERFIELD DR, TEXARKANA, TX 75503-4306
(903) 793-6135
(903) 793-0053
Mailing address
5904 SUMMERFIELD DR, TEXARKANA, TX 75503-4306
(903) 793-6135
(903) 793-0053
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
117143
TX
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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