Organization
DICKINSON PSYCHOLOGICAL SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA S DICKINSON PH.D. (OWNER)
(252) 447-7764
Entity
Organization
Contact information
Practice address
318A E MAIN ST, HAVELOCK, NC 28532-2214
(252) 447-7764
Mailing address
318A E MAIN ST, HAVELOCK, NC 28532-2214
(252) 447-7764
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
2670
NC
103TC0700X
Clinical Psychologist
Primary
2670
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045JF
BCBS
NC
05
—
6000180
—
NC
Enumeration date
05/27/2008
Last updated
06/13/2014
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