Individual
PHYLLIS L DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8990 LORRAINE RD, GULFPORT, MS 39503-4176
(228) 331-3310
(228) 284-1608
Mailing address
8990 LORRAINE RD, GULFPORT, MS 39503-4176
(228) 331-3310
(228) 284-1608
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2253C
AL
1041C0700X
Clinical Social Worker
Primary
C
MS
Other
Enumeration date
11/08/2011
Last updated
07/21/2022
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