Individual
JEFFERY KEVIN DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1 FREEDOM WAY, MAIL ROUTING NUMBER - 261, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
1 FREEDOM WAY, MAIL ROUTING NUMBER - 261, AUGUSTA, GA 30904-6258
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004268
GA
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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