Individual
MICHELLE L VICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2 KEEWAYDIN DR, SALEM, NH 03079-2839
(800) 995-2673
(888) 979-6551
Mailing address
9718 W TOWER AVE, MILWAUKEE, WI 53224-2997
(262) 483-5072
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056011092
IL
225X00000X
Occupational Therapist
075812
IA
225X00000X
Occupational Therapist
116567
TX
225X00000X
Occupational Therapist
Primary
5535-26
WI
Other
Enumeration date
02/17/2016
Last updated
03/18/2021
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