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Individual

SUSAN LYNN WICKWARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
1324 S SHERMAN ST, DENVER, CO 80210-2213
(303) 733-1701
Mailing address
1324 S SHERMAN ST, DENVER, CO 80210-2213
(303) 733-1701

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1020996
CO

Other

Enumeration date
08/27/2008
Last updated
08/27/2008
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