Provider Demographics
NPI:1699665992
Name:VIKER, MARY TAYLOR
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:TAYLOR
Last Name:VIKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 WATERSTONE TRL
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-1287
Mailing Address - Country:US
Mailing Address - Phone:678-899-3550
Mailing Address - Fax:
Practice Address - Street 1:445-1000 OLD CANTON ROAD
Practice Address - Street 2:
Practice Address - City:BALL GROUND
Practice Address - State:GA
Practice Address - Zip Code:30107
Practice Address - Country:US
Practice Address - Phone:470-264-8774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health