Individual
ISAAC WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
310 E TORRANCE, PONTIAC, IL 61764
(815) 844-6109
Mailing address
PO BOX 768, PONTIAC, IL 61764-0768
(815) 844-6109
(815) 844-3561
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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