DAVID LEE WICKSTROM

COLUMBIA, SC
NPI1366594202
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist Clinical
(Licence: SC  0591)
Enumeration Date2007-01-18
Last Update Date2007-07-08
Business Address
DR. DAVID LEE WICKSTROM PSYCHOLOGIST
7520 MONTICELLO RD
COLUMBIA, SC 29203-1516
Phone number: 803-254-3313
Mailing Address
DR. DAVID LEE WICKSTROM PSYCHOLOGIST
420 LONGTOWN RD W
BLYTHEWOOD, SC 29016-9450
Phone number: 803-318-2009
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