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General NPI Number Information
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NPI Number | 1366970352
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Entity Type | Individual
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Provider Name | DARCI JEAN WIKELIUS PSY.D., LP
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Gender | Female
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 28 UNION ST N
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City | MORA
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State | MN
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Zip | 55051-1355
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Country | US
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Telephone | 320-703-8151
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Fax |
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Provider Business Mailing Address
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Address Line | 28 UNION ST N
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City | MORA
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State | MN
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Zip | 55051-1355
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Country | US
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Telephone | 320-703-8151
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Fax | 320-210-1830
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP6996
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License Number State | MN
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