| NPI | 1871791715 |
|---|---|
| Former Name | LEORA ANN DICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44sco5324100) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY p015154-1) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2007-07-08 |