Individual
STEFAN C.M. WICKLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
1810 NW 23RD BLVD APT 263, GAINESVILLE, FL 32605-3062
(216) 308-8207
Mailing address
1810 NW 23RD BLVD APT 263, GAINESVILLE, FL 32605-3062
(216) 308-8207
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
82256
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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