Dickerson, Theresa M
Dickerson, Theresa M is an sole proprietor health care provider with primary practice located at 2625 N Meridian St , Indianapolis IN 46208-7701. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Reflexologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Specialist/Technologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist is her primary health care specialty. Dickerson, Theresa M can be contacted via phone (678) 429-3197.Contact Information
Primary practice address
2625 N Meridian St
Indianapolis IN 46208-7701
Phone: (678) 429-3197
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Reflexologist | 173C00000X | MT20901976 | Indiana |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Specialist/Technologist | 225500000X | MT20901976 | Indiana |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | MT20901976 | Indiana |
Profile Details
NPI number | 1689982613 |
---|---|
LBN Legal business name | Dickerson, Theresa M |
Credentials | LMT, CBW |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 24th, 2010 |
Last updated | Sep 24th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1689982613 | NPPES |
Indiana | Other | MT20901976 | STATE LICENSE |
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