Individual
MRS. STACEY D VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 N BOWES RD, TUCSON, AZ 85749-8589
(520) 584-7732
(520) 584-7701
Mailing address
5000 N BOWES RD, TUCSON, AZ 85749-8589
(520) 584-7732
(520) 584-7701
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
12457
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
878598
—
AZ
Enumeration date
10/17/2007
Last updated
10/17/2007
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