Individual
MR. BRANDON DICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6405 LAURELTON AVE, BALTIMORE, MD 21214-1134
(410) 622-4592
Mailing address
1724 WYCLIFFE AVE, PARKVILLE, MD 21234-6824
(410) 622-4592
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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