Individual
MS. TANYA LYNN VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
410 S. ELM ST., APPLETON, WI 54911
(920) 832-4646
(920) 832-4767
Mailing address
401 S WALNUT ST., APPLETON, WI 54911
(920) 832-4646
(920) 832-4767
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1749-121
WI
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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