| Ethel M Vicks | |
|
162 Claire Pl Talbott TN 37877-1704 | |
| (423) 353-0322 | |
| Not Available |
| Full Name | Ethel M Vicks |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 162 Claire Pl, Talbott, Tennessee |
| Authorized Official Name and Position | Ethel M Vicks (CEO) |
| Authorized Official Contact | 4233530322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethel M Vicks 162 Claire Pl Talbott TN 37877-1704 Ph: (423) 353-0322 | Ethel M Vicks 162 Claire Pl Talbott TN 37877-1704 Ph: (423) 353-0322 |
| NPI Number | 1457033805 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 08/04/2023 |
| Certification Date | 08/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457033805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |