Provider Demographics
NPI:1558345876
Name:LUMLEY, VICKI ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:ANN
Last Name:LUMLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13720 VASILI DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-6701
Mailing Address - Country:US
Mailing Address - Phone:907-580-2181
Mailing Address - Fax:907-580-1776
Practice Address - Street 1:5955 ZEAMER AVE
Practice Address - Street 2:3 MDOS/SGOH
Practice Address - City:ELMENDORF AFB
Practice Address - State:AK
Practice Address - Zip Code:99506-3702
Practice Address - Country:US
Practice Address - Phone:907-580-2089
Practice Address - Fax:907-580-1776
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1252103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical