Individual
MS. LACEY ALICE MARIE DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
10000 W. 75TH ST., SUITE 250, MERRIAM, KS 66204
(913) 894-1910
(913) 894-1174
Mailing address
10000 W. 75TH ST., SUITE 250, MERRIAM, KS 66204
(913) 894-1910
(913) 894-1174
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
17-022551
KS
225X00000X
Occupational Therapist
Primary
2009000971
MO
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
02/24/2011
Last updated
02/24/2011
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