Individual
MR. DERRICK T DICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.H.S.
Contact information
Practice address
4803 WOODLAND AVE, PHILADELPHIA, PA 19143-4433
(215) 326-9491
Mailing address
4803 WOODLAND AVE, PHILADELPHIA, PA 19143-4433
(215) 326-9491
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
251S00000X
PA
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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