Individual
TARA VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2470 ALLEN AVE, NIAGARA FALLS, NY 14303-1908
(716) 580-3556
Mailing address
131 COLDEN CT, CHEEKTOWAGA, NY 14225-5002
(716) 580-3665
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
553163-1
NY
Other
Enumeration date
08/21/2016
Last updated
08/21/2016
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