Individual
KIMBERLY DICKENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C5707
OR
Other
Enumeration date
06/27/2017
Last updated
11/28/2023
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