Provider Demographics
NPI:1093435315
Name:WIKER, JUSTINE (APSW)
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:WIKER
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 STARLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2727
Mailing Address - Country:US
Mailing Address - Phone:608-574-6308
Mailing Address - Fax:
Practice Address - Street 1:165 W NETHERWOOD ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575-1107
Practice Address - Country:US
Practice Address - Phone:608-408-9556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker