| Doctor Name: | MRS. MARY ELLEN DICKERSON |
| NPI Number: | 1225193097 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICENSED PROFESSIONA |
| License Number: | 12520 |
| Business Practice Address: | 2909 W Collin Corsicana, TX - 75110 |
| Business Phone Number: | 9038721372 |
| Business Fax Number: | 9038721372 |
| Mailing Address: | 2909 W Collin St, CORSICANA |
| State: | TX |
| Postal Code: | 75110 |
| Phone Number: | 9038721372 |
| Fax Number: | 9038721372 |
| NPI Enumeration Date: | 12/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 12520 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |