Provider Information for 1801408935
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GINA DICKISON LCPC
Sex: Female
NPI: 1801408935
Last Updated: 2020-08-19
Certification Date: 2020-08-19
Certification Date: 2020-08-19
Details
| Name | Value | ||||||||
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| NPI | 1801408935 | ||||||||
| Enumeration Date | 2020-08-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2311 BILL CT NAPERVILLE, IL 60565-5240 United States Phone: 630-421-0916 | Fax: | ||||||||
| Primary Practice Address | 2311 BILL CT NAPERVILLE, IL 60565-5240 United States Phone: 630-421-0916 | Fax: | ||||||||
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