Individual
SHANNA WICKLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
403 SUN VALLEY DR, SAINT ALBANS, WV 25177-3523
(304) 881-1479
Mailing address
403 SUN VALLEY DR, SAINT ALBANS, WV 25177-3523
(304) 881-1479
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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