Individual
MELANIE ANN WICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, COTA/L
Contact information
Practice address
12285 PECOS ST, WESTMINSTER, CO 80234-3439
(303) 280-4444
Mailing address
10886 GRANGE CREEK DR, THORNTON, CO 80233-3841
(303) 748-4247
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
0000747
CO
225200000X
Physical Therapy Assistant
Primary
0012059
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000747
COTA
CO
01
—
0012059
PTA
CO
Enumeration date
05/17/2017
Last updated
05/17/2017
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