Individual
AMY ELIZABETH DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1260 S MLK JR AVE STE D, CLEARWATER, FL 33756
(813) 416-1406
Mailing address
4107 W SPRUCE ST, STE 100, TAMPA, FL 33607-2346
(813) 636-8811
(813) 636-8855
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW16050
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102814800
—
FL
01
—
84194
SELF-PAY
FL
Enumeration date
03/12/2019
Last updated
10/20/2020
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