Individual
AYKNEPHRA VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA, CPRS
Contact information
Practice address
2775 STATE ROUTE 39, SHELBY, OH 44875-9466
(800) 680-5747
Mailing address
5413 OAKWOOD AVE, MAPLE HEIGHTS, OH 44137-2376
(216) 318-7264
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.184197
OH
175T00000X
Peer Specialist
APS.003786
OH
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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