Avery, Vicky
Avery, Vicky is an individual health care provider with primary practice located at 13560 E Mcnichols Rd , Detroit MI 48205-3426. She recently has only one registered license in Other Service Providers / Prevention Professional, which is considered as her primary health care specialty. Avery, Vicky can be contacted via phone (313) 883-3300.Contact Information
Primary practice address
13560 E Mcnichols Rd
Detroit MI 48205-3426
Phone: (313) 883-3300
Fax: (313) 731-0156
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Prevention Professional | 405300000X | 823032 | Michigan |
Profile Details
| NPI number | 1942737853 |
|---|---|
| LBN Legal business name | Avery, Vicky |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2017 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942737853 | NPPES |
| Michigan | MEDICAID | 1134502354 |
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