Individual
KEIRA BREE WICKLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1080 S MAIN ST, BLACKSBURG, VA 24060-5325
(540) 505-3326
Mailing address
1080 S MAIN ST, BLACKSBURG, VA 24060-5325
(540) 505-3326
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701014433
VA
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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