Individual
REBECCA WICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4935 HILLEGAS RD STE 200, FORT WAYNE, IN 46818-1934
(260) 338-1241
Mailing address
PO BOX 80867, FORT WAYNE, IN 46898-0867
(260) 338-1241
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004369A
IN
Other
Enumeration date
01/12/2018
Last updated
01/12/2018
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