Doctor Name: | JOHN EDWARD DICKERSON |
NPI Number: | 1376600379 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ED.D. |
License Number: | LICENSE #2202 |
Business Practice Address: | 40 Castners Rd Belvidere, NJ - 078232802 |
Business Phone Number: | 9084758100 |
Business Fax Number: | 9084758100 |
Mailing Address: | 40 Castners Rd, BELVIDERE |
State: | NJ |
Postal Code: | 078232802 |
Phone Number: | 9084758100 |
Fax Number: | 9084758100 |
NPI Enumeration Date: | 01/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | LICENSE #2202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |