Organization
LYNZE VICKERS, LMFT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNZE VICKERS LMFT (OWNER)
(334) 401-0595
Entity
Organization
Contact information
Practice address
3350 NOBLE WAY, SUITE B, VALDOSTA, GA 31605-7444
(229) 333-0300
Mailing address
3350 NOBLE WAY, SUITE B, VALDOSTA, GA 31605-7444
(229) 333-0300
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001430
GA
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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