Individual
CHASTIN NELL DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3541 NE COLIN KELLY HWY, MADISON, FL 32340-7126
(850) 464-6242
Mailing address
3541 NE COLIN KELLY HWY, MADISON, FL 32340-7126
(850) 464-6242
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18434
FL
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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