Individual
MISS JENNIFER M DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
40 BROAD STREET RD, MANAKIN SABOT, VA 23103-2213
(804) 784-3514
Mailing address
8154 SIGNAL HILL RD, MECHANICSVILLE, VA 23111-1231
(804) 730-3239
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119001291
VA
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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