Individual
KELLYN WICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.,CCC-SLP
Contact information
Practice address
803 S 20TH ST, UNIONVILLE, MO 63565-1482
(660) 947-3361
(660) 947-2912
Mailing address
803 S 20TH ST, UNIONVILLE, MO 63565-1482
(660) 947-3361
(660) 947-2912
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2014025275
MO
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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