Individual
MS. AMANDA WICKENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1515 WAZEE STREET, SUITE D, DENVER, CO 80202-1478
(303) 534-9553
(720) 932-8815
Mailing address
4900 S MONACO ST, SUITE 210, DENVER, CO 80237-3486
(303) 534-9553
(720) 932-8815
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1072823
OR
225X00000X
Occupational Therapist
31004359A
IN
225XH1200X
Hand Occupational Therapist
31004359A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200837250
—
IN
Enumeration date
10/04/2006
Last updated
08/31/2011
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