Individual
MS. BEVERLY ANNE VICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
768 E SHERWOOD HILLS DR, BLOOMINGTON, IN 47401-8178
(812) 333-8145
(812) 333-4008
Mailing address
PO BOX 8065, BLOOMINGTON, IN 47407-8065
(812) 333-8145
(812) 333-4008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22001446A
IN
Other
Enumeration date
12/10/2007
Last updated
12/10/2007
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