Individual provider · Type 1 NPI

Charles Wallace Wickliffe

Recreation Therapist · Los Angeles, CA

NPI number 1871663054 Active

Practice location

11301 Wilshire Blvd, 117R
Los Angeles, CA 90073-1003

Call (310) 478-3711 Map

Mailing address

5274 Parkglen Ave
Los Angeles, CA 90043-1030

Specialties and licenses

TaxonomyCodeLicense
Recreation Therapist Primary 225800000XNone listed

Recreation Therapist: 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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About NPI 1871663054

Charles Wallace Wickliffe's National Provider Identifier is 1871663054, issued on Nov 8, 2006. The primary taxonomy on file is Recreation Therapist (225800000X), and the practice location is in Los Angeles, CA. The record was last updated on Jul 8, 2007.