Individual
MISS CANDICE J DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 W 32ND ST, NEW YORK, NY 10001-3212
(212) 564-2350
Mailing address
136 GREEN ACRES RD, VALLEY STREAM, NY 11581-1506
(516) 445-1675
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
102437-1
NY
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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