Provider Demographics
NPI:1598045403
Name:WICKMAN, SARAH F
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:F
Last Name:WICKMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8925 N MERIDIAN ST
Mailing Address - Street 2:250
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2386
Mailing Address - Country:US
Mailing Address - Phone:317-208-7741
Mailing Address - Fax:317-581-2387
Practice Address - Street 1:8925 N MERIDIAN ST
Practice Address - Street 2:250
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2386
Practice Address - Country:US
Practice Address - Phone:317-208-7741
Practice Address - Fax:317-581-2387
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker