Individual
DANA VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13030 180TH ST, JAMAICA, NY 11434-4108
(718) 527-2200
Mailing address
22004 138TH AVE, LAURELTON, NY 11413-2325
(516) 647-3053
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
18-068
NY
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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