| Doctor Name: | MISS SHEENA G WICK |
| NPI Number: | 1255676953 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, PC-TL |
| License Number: | 1602226 |
| Business Practice Address: | 100 Polk County Plz Suite 50 Balsam Lake, WI - 548109071 |
| Business Phone Number: | 7154858430 |
| Business Fax Number: | 7154858450 |
| Mailing Address: | 100 Polk County Plz, Suite 50 BALSAM LAKE |
| State: | WI |
| Postal Code: | 548109071 |
| Phone Number: | 7154858430 |
| Fax Number: | 7154858450 |
| NPI Enumeration Date: | 12/06/2012 |
| NPI Last Update Date: | 01/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1602226 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |