| NPI | 1578064101 |
|---|---|
| Former Name | ERICA WICKSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 29604) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA SC60832295) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2023-05-24 |