Individual
MADISON DICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 SPRATT ST, FORT MILL, SC 29715-4100
(704) 931-1010
Mailing address
818 ASHWOOD WAY, EASLEY, SC 29640-8015
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
8112
SC
101YP2500X
Professional Counselor
Primary
8112
SC
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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