| NPI | 1194465104 |
|---|---|
| Other Name | THEODORE SAVAGE WICKERSHAM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 174H00000X Health Educator | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2022-03-29 |