Individual
MRS. BERNADETTE MARIE WYCKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6900 GEORGIA AVE NW, WASHINGTON, DC 20307-0003
(202) 782-6371
Mailing address
17821 TREE LAWN DR, ASHTON, MD 20861-3344
(301) 570-9068
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14708
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14708
LICENSE
MD
Enumeration date
08/18/2006
Last updated
07/08/2007
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