Individual
MRS. TRACY JEANNETTE DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A
Contact information
Practice address
350 KRESGE LANE, SPARKS, NV 89431
(775) 359-9200
Mailing address
350 KRESGE LANE, SPARKS, NV 89431
(775) 359-9200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TR0400X
Rehabilitation Psychologist
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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