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Individual

CARLIE WICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
2070 MCKENZIE STREET, #C, SPRINGDALE, AR 72762
(479) 750-7778
Mailing address
12355 RICHARDSON RD, FARMINGTON, AR 72730-9404

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OTR3536
AR
225X00000X
Occupational Therapist
Primary
OTR3537
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
458070
NATIONAL BOARD FOR CERTIFICATION OF OCCUPATIONAL THERAPY
Enumeration date
08/23/2021
Last updated
06/29/2023
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