Catherine Wickstrum

NPI #1134742950 in Meridian, Idaho

Provider Information

NPI Number: 1134742950
Entity Type: Individual
Name: Catherine Wickstrum
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: May 27, 2020
Last Updated: Feb 5, 2021

Practice Location

Address: 4966 W PHILOMENA ST
City: Meridian
State: Idaho
ZIP Code: 83646-4657
Phone: (805) 551-4156

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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