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GRACE E DICKERSON LMFT
>> Marriage & Family Therapist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1578795175
Individual Registrant: GRACE E DICKERSON LMFT
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
914C WPA RD SUMRALL, MS 39482-3780 US
Tel: 601-705-1901 Fax: --
Tel: 601-705-1901 Fax: --
Contact information for business:
914C WPA RD SUMRALL, MS 39482-3780 US
Tel: 601-705-1901 Fax: --
Tel: 601-705-1901 Fax: --
Registration Information:
NPI: 1578795175
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 106H00000X | Behavioral Health & Social Service Providers Marriage & Family Therapist | MS | M7415 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
