| Doctor Name: | MS. WENDY DICKERSON |
| NPI Number: | 1538343207 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 0904006707 |
| Business Practice Address: | 9403 A Pocahantas Trail Providence Forge, VA - 23140 |
| Business Phone Number: | 8049665959 |
| Business Fax Number: | 8049665694 |
| Mailing Address: | 10299 Woodman Road, GLEN ALLEN |
| State: | VA |
| Postal Code: | 230604419 |
| Phone Number: | 8047278517 |
| Fax Number: | 8047278703 |
| NPI Enumeration Date: | 12/18/2007 |
| NPI Last Update Date: | 04/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0904006707 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |