Individual
ALAN PAUL WALICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
1903 BEGONIA PL, PRESCOTT, AZ 86303-5029
(928) 541-9508
Mailing address
1903 BEGONIA PL, PRESCOTT, AZ 86303-5029
(928) 541-9508
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0060
AZ
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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