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Individual

JENNIFER DICKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
41 N BROAD ST, WELLSVILLE, NY 14895-1224
(607) 333-5138
(585) 593-3907
Mailing address
41 N BROAD ST, WELLSVILLE, NY 14895-1224
(607) 333-5138
(585) 593-3907

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
NYCPS-P-585
NY

Other

Enumeration date
01/14/2016
Last updated
01/14/2016
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