NPI | 1043876014 |
---|---|
Former Name | BRITTANY L VICKERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701008021) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000405) |
Enumeration Date | 2019-05-15 |
Last Update Date | 2023-11-28 |