Individual
AMANDA MICHELLE VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1601 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 558-5795
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH61411802
WA
101YP2500X
Professional Counselor
11371
OK
101YP2500X
Professional Counselor
77772
TX
Other
Enumeration date
04/09/2019
Last updated
07/12/2023
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