Provider Demographics
NPI:1962370932
Name:WICKRE, ABBY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:WICKRE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 2ND ST N
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:IA
Mailing Address - Zip Code:50548-2522
Mailing Address - Country:US
Mailing Address - Phone:515-890-3712
Mailing Address - Fax:
Practice Address - Street 1:30 TAFT ST N
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:IA
Practice Address - Zip Code:50548-1769
Practice Address - Country:US
Practice Address - Phone:307-274-8705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA126274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty