Doctor Name: | MS. TRACY N. VICKERS |
NPI Number: | 1245528819 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LC3901 |
Business Practice Address: | 7295 Buttercup Rd Sykesville, MD - 217847463 |
Business Phone Number: | 4107955767 |
Business Fax Number: | 4107956770 |
Mailing Address: | 7295 Buttercup Rd, SYKESVILLE |
State: | MD |
Postal Code: | 217847463 |
Phone Number: | 7033508366 |
Fax Number: | 7032430975 |
NPI Enumeration Date: | 07/18/2011 |
NPI Last Update Date: | 09/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LC3901 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |