Individual
DR. KEVIN L WICKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
9 RICHLAND MEDICAL PARK DR, SUITE 440, COLUMBIA, SC 29203-6859
(803) 434-2767
(803) 434-2850
Mailing address
9 RICHLAND MEDICAL PARK DR, SUITE 440, COLUMBIA, SC 29203-6859
(803) 434-2767
(803) 434-2850
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3694
SC
Other
Enumeration date
07/09/2009
Last updated
07/09/2009
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