Individual
DANIEL WICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 ELIZABETH PL STE 190, DAYTON, OH 45417-3445
(937) 652-6811
Mailing address
4751 FISHER TWIN RD, WEST ALEXANDRIA, OH 45381-8309
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E.0003656-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117471
—
OH
05
—
0119089
—
OH
Enumeration date
06/15/2017
Last updated
06/15/2017
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