Individual
DEBRA JEAN DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA;CCC-SLP
Contact information
Practice address
301 W POWELL ST, HAXTUN, CO 80731-2654
(970) 521-2771
(970) 774-6157
Mailing address
PO BOX 98, HAXTUN, CO 80731-0098
(970) 521-2771
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
230981
CO
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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