Individual
CLARISSA WICKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3720 GRANTSVILLE DR, FORT WORTH, TX 76244-5761
(251) 533-5520
Mailing address
3720 GRANTSVILLE DR, FORT WORTH, TX 76244-5761
(251) 533-5520
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
203398
TX
Other
Enumeration date
11/29/2021
Last updated
12/05/2022
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