Charles Wallace Wickliffe in Los Angeles - Recreation Therapist
Charles Wallace Wickliffe - NPI 1871663054
Charles Wallace Wickliffe is a Recreation Therapist in Los Angeles, California. Charles Wallace Wickliffe practices all healthcare services and medical treatments related to Recreation Therapist. The NPI Number for Charles Wallace Wickliffe is 1871663054. The last update date is 2007-07-08.
Charles Wallace Wickliffe's current location address is 5274 Parkglen Ave, Los Angeles, California. You can contact this provider via phone number 3232999755. The mailing address for Charles Wallace Wickliffe is 5274 Parkglen Ave, Los Angeles, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Charles Wallace Wickliffe |
|---|---|
| Address | 5274 Parkglen Ave, Los Angeles, California |
| Phone Number | 3232999755 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1871663054 |
|---|---|
| Provider Enumeration Date | 2006-11-08 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 5274 Parkglen Ave |
|---|---|
| City | Los Angeles |
| State | California (CA) |
| Post Code | 900431030 |
| Phone Number | 3232999755 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Recreation Therapist |
|---|---|
| Taxonomy | 225800000X |
|
Definition: A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |
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Post Comment/ Review Below
What is the unique identifier code issued to Charles Wallace Wickliffe by the Centers for Medicare & Medicaid Services (CMS)?
The Charles Wallace Wickliffe has been assigned the NPI (National Provider Identifier) 1871663054. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Charles Wallace Wickliffe?
The Charles Wallace Wickliffe is situated at 5274 Parkglen Ave, in the city of Los Angeles, state of CA, with the zip code 900431030.
What is the area of specialization for Charles Wallace Wickliffe, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Charles Wallace Wickliffe is Recreation Therapist, and the corresponding taxonomy code that categorizes this area of expertise is 225800000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1871663054 to Charles Wallace Wickliffe?
The Centers for Medicare & Medicaid Services assigned the 1871663054 to Charles Wallace Wickliffe on 2006-11-08.
When was the information regarding Charles Wallace Wickliffe, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Charles Wallace Wickliffe, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.
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