Individual
MR. JOSEPH LEE DICKERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. ED
Contact information
Practice address
872 VERNON ST, MANCHESTER, CT 06042-2415
(860) 882-9117
Mailing address
872 VERNON ST, MANCHESTER, CT 06042-2415
(860) 882-9117
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C022013000914
CT
101YP2500X
Professional Counselor
C022013000914
CT
Other
Enumeration date
04/30/2013
Last updated
04/30/2013
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