Individual
DANIEL WICKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSCSW
Contact information
Practice address
16979 W 94TH ST, LENEXA, KS 66219
(785) 640-2411
Mailing address
16979 W 94TH ST, LENEXA, KS 66219
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4814
KS
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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