BONITA RAE WICKSTROM

ALBUQUERQUE, NM
NPI1225075161
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
(Licence: NM  I-4390)
Enumeration Date2006-05-31
Last Update Date2007-07-08
Business Address
Ms. BONITA RAE WICKSTROM LISW
12836 LOMAS BLVD NE SUITE B
ALBUQUERQUE, NM 87112-6210
Phone number: 505-453-7862
Mailing Address
Ms. BONITA RAE WICKSTROM LISW
14507 ENCANTADO RD NE
ALBUQUERQUE, NM 87123-2249
Phone number: 505-275-7795
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