Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KATHLEEN ELAINE VICKERS I
Active Sole ProprietorMethadone Clinic · FITCHBURG, MA
Registration Details
- NPI Number
- 1043888514
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 11, 2021 (4.8606043583224 yrs)
- Last Updated
- Jun 11, 2021
- License
-
S90889172 (MA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1005 MAIN STFITCHBURG, MA, 014203179Browse MA providers · Browse ZIP 01420
- Phone
- 1603475519
- Primary Specialty
-
Methadone Clinic
261QM2800X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.