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Individual
SUSANE A. DICKSON
Active
Individual
SUSANE A. DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
264742
MA
208000000X
Pediatrics Physician
ME71623
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD17188
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258302000
—
FL
Enumeration date
11/03/2006
Last updated
08/20/2020
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