Individual
ANNE MARIE VICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R-DMT
Contact information
Practice address
483 CLERMONT AVE, BROOKLYN, NY 11238-2253
(718) 643-5300
Mailing address
483 CLERMONT AVE, BROOKLYN, NY 11238-2253
(718) 643-5300
Taxonomy
Speciality
Code
Description
License number
State
225600000X
Dance Therapist
Primary
P107084
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P107084
—
NY
Enumeration date
10/01/2020
Last updated
10/01/2020
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