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Individual
FREDERICK MARCUS VICKERY
Active
Individual
FREDERICK MARCUS VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPPC, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304457
MN
101YP2500X
Professional Counselor
Primary
1835
MN
Other
Enumeration date
12/15/2017
Last updated
09/04/2026
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