Individual
MRS. PAULETTE VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMFT
Contact information
Practice address
1012 CHARLES ST, LOUISVILLE, KY 40204-2406
(502) 634-8435
Mailing address
1012 CHARLES ST, LOUISVILLE, KY 40204-2406
(502) 634-8435
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1646
KY
Other
Enumeration date
05/16/2007
Last updated
08/27/2015
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