Individual
DEANDRA DOMINIQUE DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9145 13TH AVE, JACKSONVILLE, FL 32208
(904) 723-9713
Mailing address
9145 13TH AVE, JACKSONVILLE, FL 32208
(904) 723-9713
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
281051
FL
Other
Enumeration date
01/31/2021
Last updated
01/31/2021
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