Individual
JANE DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCSP
Contact information
Practice address
PVS -1574, ST.RD. 502, SANTA FE, NM 87501
(505) 455-0801
(505) 455-3023
Mailing address
P.O.BOX 3468, POJOAQUE STATION, SANTA FE, NM 87501-0468
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
289712
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09288082
—
NM
Enumeration date
05/02/2007
Last updated
07/08/2007
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