Individual
MRS. PENNY WEST DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
210 HOSPITAL CIR, CHOCTAW, MS 39350-6781
(601) 389-4132
Mailing address
210 HOSPITAL CIR, CHOCTAW, MS 39350-6781
(601) 389-4132
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-0579
MS
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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