Individual
DR. LATREECE EVETTE DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
9933 S WESTERN AVE STE 203, CHICAGO, IL 60643-1810
(312) 730-3966
(312) 803-1635
Mailing address
9933 S WESTERN AVE STE 203, CHICAGO, IL 60643-1810
(312) 730-3966
(312) 803-1635
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071009102
IL
1041C0700X
Clinical Social Worker
149-008520
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437667805
PARTNERSHIPS IN BEHAVIORAL HEALTH
IL
Enumeration date
10/10/2006
Last updated
11/10/2023
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