Individual
VICKI PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
792 N MAIN ST STE 100B, NORTH SYRACUSE, NY 13212-1661
(315) 299-6975
Mailing address
792 N MAIN ST STE 100B, NORTH SYRACUSE, NY 13212-1661
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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