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Crystal Marie Dickerson
Professional Counselor in Modesto, California
NPI 1871917468

Crystal Marie Dickerson is a Professional Counselor based in Modesto, CA and is specialized in Professional. Crystal Marie Dickerson practices in Modesto, CA. The NPI Number for Crystal Marie Dickerson is 1871917468 and holds a License No. (California).

The current practice location address for Crystal Marie Dickerson is 121 Downey Ave, Modesto, CA and can be reached out via phone at 209-341-1824.

Location: 121 Downey Ave, Modesto, CA, 95354-1208
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871917468
Provider Name
Crystal Marie Dickerson
Credential
Provider Entity Type
Individual
Gender
Female
Address
121 Downey Ave, Modesto, CA, 95354-1208
Phone Number
209-341-1824
Fax Number
Provider Enumeration Date
02/18/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
121 Downey Ave
City
Modesto
State
California
Zip
95354-1208
Phone Number
209-341-1824
Fax Number
person
Provider Business Mailing Address Details
Address
121 Downey Ave
City
Modesto
State
California
Zip
95354-1208
Phone Number
209-341-1824
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
132613 ()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
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