Provider Information for 1518435759
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VALENCIA DESHANE DICKERSON LPCC
Sex: Female
NPI: 1518435759
Last Updated: 2019-04-30
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1518435759 | ||||||||||||||||
| Enumeration Date | 2018-11-06 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 677 HAWTHORNE AVE CINCINNATI, OH 45205-2318 United States Phone: 606-356-9741 | Fax: | ||||||||||||||||
| Primary Practice Address | 525 W 5TH ST COVINGTON, KY 41011-1259 United States Phone: 606-356-9741 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 200 HOME RD | ||||||||||||||||
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