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General NPI Number Information
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NPI Number | 1003207705
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Entity Type | Individual
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Provider Name | TONICA WICKER LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 5018 PHEASANT CREST RD
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City | EDMOND
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State | OK
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Zip | 73034-9205
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Country | US
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Telephone | 808-292-4919
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Fax |
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Provider Business Mailing Address
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Address Line | 5018 PHEASANT CREST RD
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City | EDMOND
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State | OK
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Zip | 73034-9205
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Country | US
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Telephone | 808-292-4919
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11983
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | TPMC3197
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LH60461035
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60461035
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License Number State | WA
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