Individual
GREGORY DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4477 W EMERALD ST, SUITE C100, BOISE, ID 83706-2000
(208) 321-0160
(208) 321-0221
Mailing address
4477 W EMERALD ST, SUITE C100, BOISE, ID 83706-2000
(208) 321-0160
(208) 321-0221
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-42076
ID
Other
Enumeration date
03/03/2014
Last updated
04/14/2022
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