Individual
MRS. MARY ELIZABETH ANN DICKOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.,CPRP
Contact information
Practice address
3763 EVANS AVE, FORT MYERS, FL 33901-9302
(239) 332-6937
(239) 332-6985
Mailing address
3763 EVANS AVE, FORT MYERS, FL 33901-9302
(239) 931-9827
(239) 332-6985
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
171637
FL
Other
Enumeration date
07/15/2013
Last updated
08/01/2013
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