Individual
DOMINIQUE DICKESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
814 COMMERCE DR STE 100, OAK BROOK, IL 60523-8822
(630) 526-4170
Mailing address
814 COMMERCE DR STE 100, OAK BROOK, IL 60523-8822
(630) 526-4170
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB535178
IL
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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