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Organization
ETHEL M VICKS
Active
Organization
ETHEL M VICKS
Active
Other names
Make A Way For Adults
Organization subpart
No
Provider details
NPI number
Authorized official
ETHEL M VICKS (CEO)
(423) 353-0322
Entity
Organization
Contact information
Practice address
162 CLAIRE PL, TALBOTT, TN 37877-1704
(423) 353-0322
Mailing address
162 CLAIRE PL, TALBOTT, TN 37877-1704
(423) 353-0322
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/04/2023
Last updated
08/04/2023
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