Individual
MR. TIM J MCVICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADAC II
Contact information
Practice address
255 N. MIAMI ST., WABASH, IN 46992
(260) 563-8446
(260) 563-1902
Mailing address
850 N. HARRISON ST., WARSAW, IN 46580
(574) 267-7169
(574) 269-3995
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A1431R
IN
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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