Individual
AMY WICKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1252 S AVONDALE BLVD, AVONDALE, AZ 85323-8900
(623) 478-5600
Mailing address
1252 S AVONDALE BLVD, AVONDALE, AZ 85323-8900
(623) 478-5600
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
D01414131
AZ
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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