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Individual

MARION MAROLD VICKERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LMFT

Contact information

Practice address
4749 ODOM RD, BEAUMONT, TX 77706-7080
(409) 200-2220
(409) 440-3344
Mailing address
105 CANYON LAKE CIR, LUMBERTON, TX 77657-3701
(409) 200-2220
(409) 440-3344

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
202574
TX
106H00000X
Marriage & Family Therapist
CO 613
CO

Other

Enumeration date
05/03/2013
Last updated
11/14/2023
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