Individual
MS. LAVINA CERERIS DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10708 LUPINE CIR, SEWARD, AK 99664-1981
(907) 599-0534
Mailing address
PO BOX 1981, SEWARD, AK 99664-1981
(907) 599-0534
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
162301
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162301
STATE OF ALASKA MASSAGE LICENSE
AK
Enumeration date
02/18/2021
Last updated
02/18/2021
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