Individual
ANNA VICKREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
5017 OAK AVE, YOUNGSTOWN, FL 32466-2024
(855) 832-6727
Mailing address
4575 SE DIXIE HWY, STUART, FL 34997-6826
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
16-22541
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021196500
—
FL
Enumeration date
07/23/2017
Last updated
07/23/2017
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