Individual
EMILY WICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 BELLE VISTA HTS, PORTLAND, CT 06480-1672
(860) 997-6679
Mailing address
22 BELLE VISTA HTS, PORTLAND, CT 06480-1672
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4680
CT
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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