Individual
DANIEL T WICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
689 COUNTY ROAD 4855, TIMPSON, TX 75975-5327
(936) 668-1066
(936) 647-1789
Mailing address
PO BOX 51, TIMPSON, TX 75975-0051
(936) 668-1066
(936) 647-1789
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
15745
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177329301
—
TX
Enumeration date
02/26/2007
Last updated
08/19/2010
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