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Individual

DESTINY VICKERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
106 PASCO ST, BEREA, KY 40403-1529
(859) 646-6256
Mailing address
127 QUICK RD, NEW CARLISLE, OH 45344-9253
(937) 845-3628

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
02/08/2023
Last updated
02/08/2023
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