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General NPI Number Information
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NPI Number | 1689911604
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Entity Type | Individual
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Provider Name | SONIA LYNN WICHMANN LPC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/10/2013
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 200 W SUMMIT AVE
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City | WALES
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State | WI
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Zip | 53183-9427
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Country | US
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Telephone | 262-433-6673
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Fax |
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Provider Business Mailing Address
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Address Line | S19W37677 PASTEUR CT
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City | DOUSMAN
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State | WI
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Zip | 53118-8726
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Country | US
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Telephone | 262-433-6673
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4907-125
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 917-124
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License Number State | WI
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