Individual
SARAH K WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LP
Contact information
Practice address
680 STEWART AVE, SAINT PAUL, MN 55102-4117
(651) 292-2424
Mailing address
15251 PLEASANT VALLEY RD, CENTER CITY, MN 55012-9640
(651) 292-2424
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP5316
MN
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
LP 5316
MN
103TP2701X
Group Psychotherapy Psychologist
LP 5316
MN
Other
Enumeration date
10/06/2008
Last updated
10/29/2018
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