Individual
ANGELA DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5612 26TH ST W, BRADENTON, FL 34207-3515
(941) 751-6532
Mailing address
8323 EAGLE ISLES PL, BRADENTON, FL 34212-9323
(941) 527-1423
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10564
FL
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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