Individual
DR. DANA JICKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
4550 CLYDE MORRIS BLVD STE B, PORT ORANGE, FL 32129-4080
(386) 265-4769
(386) 774-2898
Mailing address
4550 CLYDE MORRIS BLVD STE B, PORT ORANGE, FL 32129-4080
(386) 265-4769
(386) 774-2898
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY2012
FL
Other
Enumeration date
02/18/2016
Last updated
02/03/2020
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