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1114484128
MATTHEW WAYNE DICKENS
CULVER CITY, CA
NPI
1114484128
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-02-26
Last Update Date
2019-02-26
Business Address
MATTHEW WAYNE DICKENS
4760 SEPULVEDA BLVD
CULVER CITY, CA 90230-4820
Phone number: 310-390-6612
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Mailing Address
MATTHEW WAYNE DICKENS
1007 MYRTLE AVE
INGLEWOOD, CA 90301-4009
Phone number: 310-412-4191
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