Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. CHARLES WALLACE WICKLIFFE
Active Sole ProprietorMR. CHARLES WALLACE WICKLIFFE is a Recreation Therapist healthcare provider located in LOS ANGELES, California. NPI 1871663054 is currently active in the NPPES registry. Verify at CMS.
Recreation Therapist · LOS ANGELES, CA
Registration Details
- NPI Number
- 1871663054
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 8, 2006 (19.721148339114 yrs)
- Last Updated
- Jul 8, 2007
- Sole Proprietor
- Yes
Practice Information
- Address
-
11301 WILSHIRE BLVD117RLOS ANGELES, CA, 900731003Browse CA providers · Browse ZIP 90073
- Phone
- 3104783711
- Primary Specialty
-
Recreation Therapist
225800000X
Other Recreation Therapist Providers in LOS ANGELES, CA
| Name | Credential | NPI |
|---|---|---|
| RAMONA ANITA SPILLER | CTRS | 1124111042 |
| MS. SETHER M. HILLS | M.S. | 1558444745 |
| MS. MIRIAN B. FRANKLIN | B.A. | 1154406346 |
| MR. BRUCE HOWARD GARRET | C.T.R.S. | 1053490672 |
| MRS. RAMONA LYNN JOHNSON-HACKETT | BS,RTC | 1558430538 |
| RANDI ALPERN | RT | 1932279536 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.