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1396841839
DAVID ALFRED WICKMAN
APPLETON, WI
NPI
1396841839
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 1624)
Enumeration Date
2006-09-15
Last Update Date
2007-07-08
Business Address
Mr. DAVID ALFRED WICKMAN addiction therapist
10 TRI PARK WAY
APPLETON, WI 54914-1658
Phone number: 920-831-7908
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Mailing Address
Mr. DAVID ALFRED WICKMAN addiction therapist
1836 PREBLE AVE
GREEN BAY, WI 54302-2937
Phone number: 920-437-3863
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