Individual provider · Type 1 NPI

Dominique Gabrielle Vickers

Student in an Organized Health Care Education/Training Program · Boston, MA

NPI number 1144064239 Active

Practice location

1 Kneeland St
Boston, MA 02111-1527

Call (617) 636-6828 Map

Other practice locations

  • 511 E 3rd St Ste 260, Bethlehem, PA 18015-2072 · (484) 526-2460

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1144064239

Dominique Gabrielle Vickers's National Provider Identifier is 1144064239, issued on Jun 24, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Boston, MA. The record was last updated on Apr 6, 2026.