Tina Wickersham, LMHC Temp
Counselor, Mental Health in Sioux City, IA. Individual provider (NPI-1).
NPI number1982159125
StatusActive
Last updated in NPPESAug 17, 2016
Details
- NPI
- 1982159125
- Entity type
- Individual (NPI-1)
- Name
- Tina Wickersham
- Credential
- LMHC Temp
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 17, 2016
- Last updated
- Aug 17, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 084138 | IA | Yes |
Practice location
4323 Vine AveSioux City, IA 51106-1958
Phone 712-202-0777 · Fax 712-202-0780
Mailing address
4323 Vine AveSioux City, IA 51106-1958
Phone 712-202-0777 · Fax 712-202-0780
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