Organization
WHOLEHEARTED INTEGRATIVE BODYMIND THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE L BICKHAM PHD (OWNER)
(414) 858-8085
Entity
Organization
Contact information
Practice address
1035 W GLEN OAKS LN STE 204, MEQUON, WI 53092-3395
(414) 858-8085
Mailing address
661 LAVERNE DR, GREEN BAY, WI 54311-5931
(414) 858-8085
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100072756
—
WI
Enumeration date
07/04/2018
Last updated
02/03/2025
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