Wickstrom, Matthew David

Wickstrom, Matthew David is an individual health care provider with primary practice located at 27880 N 64Th Street , Scottsdale AZ 85262. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Wickstrom, Matthew David can be contacted via phone (480) 202-8454.

Contact Information

Primary practice address
27880 N 64Th Street Scottsdale AZ 85262
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 4058847 Arizona

Profile Details

NPI number 1801040878
LBN Legal business name Wickstrom, Matthew David
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2008
Last updated Nov 4th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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