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Individual

MRS. TAMERIA B VICKERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2400 S RIDGEWOOD AVE, SOUTH DAYTONA, FL 32119-3097
(386) 304-7600
Mailing address
1821 PLUMTREE DR, DELTONA, FL 32725-3283
(407) 435-0143

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
09/24/2018
Last updated
09/24/2018
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