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NPI Profile for TAMIIKA VINCENT in RAYMORE, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X |
| NPI # | 1437397403 |
|
| Status | Active | |
| Credentials | PROVISIONAL LPE | |
| Entity | Individual | |
| Enumeration date | 01/29/2009 | |
| Last updated | 01/29/2009 - About 17 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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TAMIIKA VINCENT
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TAMIIKA VINCENT, PROVISIONAL LPE