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Individual

AMY WICKLIFFE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
685 SHELBY TRL STE 105, CONWAY, AR 72034-7169
(501) 410-0092
Mailing address
PO BOX 414, GREENBRIER, AR 72058-0414
(501) 679-0232

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
2394-M
AR
1041C0700X
Clinical Social Worker
Primary
6170-C
AR

Other

Enumeration date
03/29/2010
Last updated
08/26/2024
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