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1346901741
COREY ELIZABETH WICEVIC
RALEIGH, NC
NPI
1346901741
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-01-07
Last Update Date
2022-01-07
Business Address
COREY ELIZABETH WICEVIC
5121 KINGDOM WAY STE 100
RALEIGH, NC 27607-6063
Phone number: 828-236-1547
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Mailing Address
COREY ELIZABETH WICEVIC
22 ASCENSION DR APT L
ASHEVILLE, NC 28806-1950
Phone number: 815-931-3529
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