Most Relevant Information
Provider Data
| NPI Number: | 1003667122 |
| Provider Name: | NICOLE WIK |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/27/2024 |
| Last Updated: | 07/10/2024 |
Provider Practice Location
1875 S GENEVA RD
OREM
UT
840582217
Practice Location Phone/Fax
| Phone: | 8014370490 |
| Fax: |
Provider Mailing Location
6222 W IH 10 STE 104
SAN ANTONIO
TX
782012013
Provider Mailing Phone/Fax
| Phone: | 2104470039 |
| Fax: |