| NPI | 1891123808 |
|---|---|
| Former Name | ANGELA MARIE WICHMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 01630) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 852) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2013-10-30 |