Individual
CHRISTY WICKLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
804 INDUSTRIAL PARK RD, #1, MAXWELTON, WV 24957-8066
(304) 497-0500
(304) 497-0516
Mailing address
131 WELLNESS DR, SUMMERSVILLE, WV 26651-5402
(304) 872-6503
(304) 872-5415
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
BP00944176
WV
1041C0700X
Clinical Social Worker
Primary
DP00944176
WV
Other
Enumeration date
12/11/2014
Last updated
04/19/2022
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