Individual
MS. KELLY S DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7 MUNICIPAL WAY, EDGEWOOD, NM 87015
(505) 873-7462
Mailing address
7 MUNICIPAL WAY, FIRST CHOICE COMMUNITY HEALTHCARE, INC, EDGEWOOD, NM 87015-7086
(505) 873-7462
(505) 241-5188
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M-08815
NM
1041C0700X
Clinical Social Worker
Primary
C-10136
NM
Other
Enumeration date
08/26/2009
Last updated
06/15/2020
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