Individual
MRS. ELIZABETH BENTLEY DICKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
430 W MAIN ST, DOTHAN, AL 36301-1616
(334) 677-6955
Mailing address
126 VANN DR, ASHFORD, AL 36312-3406
(334) 899-3612
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1847
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1847
SPEECH THERAPY LICENSE
AL
Enumeration date
11/27/2006
Last updated
07/08/2007
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