Individual
MR. KERN NEIL DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
576 STATE ST, SPRINGFIELD, MA 01109-4104
(508) 839-2322
(508) 839-0241
Mailing address
576 STATE STREET, SPRINGFIELD, MA 01109
(508) 839-2322
(508) 839-0241
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306839
—
MA
Enumeration date
02/19/2009
Last updated
02/19/2009
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