| NPI | 1801306055 |
|---|---|
| Former Name | ELIZABETH DIANA DICKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801114019) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2022-02-01 |