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Individual
MRS. JENNIFER IRENE DICKINSON
Active
Individual
MRS. JENNIFER IRENE DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PT2782
ME
225100000X
Physical Therapist
10177
NC
225100000X
Physical Therapist
Primary
PENDING
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048150
ANTHEM BC/BS ID NUMBER
ME
05
—
249760099
—
ME
Enumeration date
06/20/2006
Last updated
06/20/2025
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