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General NPI Number Information
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NPI Number | 1669645503
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Entity Type | Organization
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Legal Business Name | JOSEPH F. WICKER, PSY.D. CLINICAL PSYCHOLOGIST, LLC.
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 04/11/2008
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Provider Practice Location Address
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Address Line | 4030 MOUNT CARMEL TOBASCO RD 306E
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City | CINCINNATI
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State | OH
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Zip | 45255-3400
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Country | US
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Telephone | 513-528-2245
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Fax | 513-528-2184
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Provider Business Mailing Address
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Address Line | 4030 MOUNT CARMEL TOBASCO RD 306E
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City | CINCINNATI
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State | OH
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Zip | 45255-3400
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Country | US
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Telephone | 513-528-2245
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Fax | 513-528-2184
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JOSEPH F. WICKER
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Credential | PSY.D.
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Telephone | 513-528-2245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3625
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License Number State | OH
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