KELLY LEE WICKHAM

LOS ANGELES, CA
NPI1548476104
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-05-14
Last Update Date2007-07-08
Business Address
Mrs. KELLY LEE WICKHAM
1147 S ALVARADO ST
LOS ANGELES, CA 90006-4100
Phone number: 213-381-8526
Mailing Address
Mrs. KELLY LEE WICKHAM
752 GLENWOOD RD
GLENDALE, CA 91202-1575
Phone number: 818-242-9357
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