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General NPI Number Information
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NPI Number | 1699665992
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Entity Type | Individual
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Provider Name | MARY TAYLOR VIKER
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Gender | Female
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 445-1000 OLD CANTON ROAD
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City | BALL GROUND
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State | GA
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Zip | 30107
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Country | US
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Telephone | 470-264-8774
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Fax |
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Provider Business Mailing Address
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Address Line | 172 WATERSTONE TRL
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City | CANTON
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State | GA
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Zip | 30114-1287
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Country | US
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Telephone | 678-899-3550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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