Individual
KIMBERLY WICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4200
Mailing address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4562
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4940
WI
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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