Individual
KENISHA MELISSA DICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 E LIBERTY ST # 1-C, SUMTER, SC 29150-5237
(803) 236-0139
Mailing address
20 E LIBERTY ST # 1-C, SUMTER, SC 29150-5237
(803) 236-0139
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IHCP-1471
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
871183504
AGENCY
SC
Enumeration date
06/28/2022
Last updated
07/18/2022
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