Individual
JOHANNAH LOGAN WICKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
406A ASH ST, LOWELL, AR 72745-9629
(479) 879-4241
Mailing address
406 ASH ST # A, LOWELL, AR 72745-9629
(479) 879-4241
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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