Individual
GARRY DEAN WICKERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
204 AUBURN ST, PORTLAND, ME 04103-2134
(207) 558-3262
Mailing address
204 AUBURN ST, PORTLAND, ME 04103-2134
(207) 558-3262
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS1756
ME
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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