Individual
ANISSA ELIZABETH DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
850 HARRISON AVE, YACC 5, BOSTON, MA 02118-4001
(617) 414-2080
(617) 414-2090
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
2278970
MA
Other
Enumeration date
06/19/2012
Last updated
11/18/2016
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