Individual
DR. BONNIE R. WICKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
711 H ST, SUITE 400, ANCHORAGE, AK 99501-3416
(907) 274-1333
(907) 276-7004
Mailing address
711 H ST, SUITE 400, ANCHORAGE, AK 99501-3416
(907) 274-1333
(907) 276-7004
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
517
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS9863
—
AK
Enumeration date
12/06/2006
Last updated
07/09/2007
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