KACY WICKERSON

CHARLOTTE, NC
NPI1831620855
Former NameKACY BROWN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: NC  12381)
Additional Taxonomies235Z00000X Speech-Language Pathologist,
(Licence: GA  SLP011439)
235Z00000X Speech-Language Pathologist,
(Licence: SC  6006)
Enumeration Date2017-03-22
Last Update Date2022-02-07
Business Address
KACY WICKERSON
11112 SCRIMSHAW LN
CHARLOTTE, NC 28215-8304
Phone number: 704-258-7031
Mailing Address
KACY WICKERSON
11112 SCRIMSHAW LN
CHARLOTTE, NC 28215-8304
Phone number: 704-258-7031