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Organization

ETHEL M VICKS

Active
Other names
Make A Way For Adults
Organization subpart
No

Provider details

NPI number
Authorized official
ETHEL M VICKS (CEO)
(423) 353-0322
Entity
Organization

Contact information

Practice address
162 CLAIRE PL, TALBOTT, TN 37877-1704
(423) 353-0322
Mailing address
162 CLAIRE PL, TALBOTT, TN 37877-1704
(423) 353-0322

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
106H00000X
Marriage & Family Therapist

Other

Enumeration date
08/04/2023
Last updated
08/04/2023
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