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NPI Code Detail

MEDICARE: MRS. MARLA MCALLISTER WICKER MS, CCC-SLP

MEDICARE: MRS. MARLA MCALLISTER WICKER MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist5840NC

General Provider Information

NPI Number : 1619133543
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARLA MCALLISTER WICKER MS, CCC-SLP
Provider Business Mailing Address
First Line : 5330 RAEFORD RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3074
Country : US
Telephone Number : 910-488-4100
Fax Number : 910-483-8721
Provider Business Practice Location Address
First Line : 5330 RAEFORD RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3074
Country : US
Telephone Number : 910-488-4100
Fax Number : 910-483-8721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2008
Last Update Date : 05/02/2014

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Directions to “ MRS. MARLA MCALLISTER WICKER MS, CCC-SLP” Practice Location

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