| NPI | 1215241161 |
|---|---|
| Former Name | KAREN MARIE WICKLINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: MI 6361003201) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301014516) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2023-08-29 |