Individual
DE ANNA DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1120 46TH STREET PL, MOLINE, IL 61265-2651
(309) 762-3006
Mailing address
1120 46TH STREET PL, MOLINE, IL 61265-2651
(309) 762-3006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.002979
IL
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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