Individual
ADEA DICKERSON-RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1490 E MAIN ST, COLUMBUS, OH 43205-2140
(614) 252-0731
Mailing address
1490 E MAIN ST, COLUMBUS, OH 43205-2140
(614) 252-0731
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/24/2021
Last updated
05/21/2025
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